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https://www.readbyqxmd.com/read/28957998/previous-lung-volume-reduction-surgery-does-not-negatively-affect-survival-after-lung-transplantation
#1
Ilhan Inci, Ilker Iskender, Jonas Ehrsam, Claudio Caviezel, Sven Hillinger, Isabelle Opitz, Didier Schneiter, Walter Weder
OBJECTIVES: Lung volume reduction surgery (LVRS) and lung transplantation (LTx) are the treatments of choice in selected patients with end-stage emphysema. Recently, the history of LVRS has been questioned due to reduced post-transplant survival. We aim to address this question by reviewing our experience, which is the largest single-centre series of LVRS followed by LTx. METHODS: We reviewed our prospectively recorded database in patients with emphysema undergoing LTx between 1993 and 2014...
September 8, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28950329/long-term-survival-and-symptomatic-relief-in-lower-lobe-lung-volume-reduction-surgery
#2
Periklis Perikleous, Annabel Sharkey, Inger Oey, Rocco Bilancia, Sara Tenconi, Sridhar Rathinam, David A Waller
OBJECTIVES: Lung volume reduction surgery (LVRS) has been demonstrated to provide symptomatic relief and improve lung function in patients with end-stage emphysema. The National Emphysema Treatment Trial specifically noted functional benefits in patients with predominantly upper lobe emphysema and demonstrated improvement in quality-of-life parameters, in patients with non-upper lobe emphysema and a low-baseline exercise capacity. We aimed to investigate whether physiological and health status benefits correlated with lower lobe LVRS...
July 31, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28835891/patient-experience-of-lung-volume-reduction-procedures-for-emphysema-a-qualitative-service-improvement-project
#3
Sara Buttery, Adam Lewis, Inger Oey, Joanne Hargrave, David Waller, Michael Steiner, Pallav L Shah, Samuel V Kemp, Simon Jordan, Nicholas S Hopkinson
The aim of this service improvement project was to gain understanding of the patient experience of lung volume reduction surgery (LVRS) and endobronchial valve (EBV) placement, from referral through to post-discharge care. Focus group interviews were carried out in two tertiary centres in London and Leicester, UK. Sixteen patients who had undergone lung volume reduction surgery (LVRS), endobronchial valve (EBV) placement, or both, were recruited. Prior to participation in each focus group, participants completed a questionnaire to guide and focus discussion...
July 2017: ERJ Open Research
https://www.readbyqxmd.com/read/28750097/compensatory-lung-growth-after-bilobectomy-in-emphysematous-rats
#4
Francine Maria Almeida, Beatriz Mangueira Saraiva-Romanholo, Rodolfo Paula Vieira, Henrique Takachi Moriya, Ana Paula Ligeiro-de-Oliveira, Fernanda Dtqs Lopes, Hugo C Castro-Faria-Neto, Thais Mauad, Milton Arruda Martins, Rogerio Pazetti
Lung volume reduction surgery (LVRS) is an option for emphysematous patients who are awaiting lung transplantation. LVRS reduces nonfunctional portions of lung tissues and favors the compensatory lung growth (CLG) of the remaining lobes. This phenomenon diminishes dyspnea and improves both the respiratory mechanics and quality of life for the patients. An animal model of elastase-induced pulmonary emphysema was used to investigate the structural and functional lung response after LVRS. Bilobectomy was performed six weeks after elastase instillation...
2017: PloS One
https://www.readbyqxmd.com/read/28572121/individualised-risk-in-patients-undergoing-lung-volume-reduction-surgery-the-glenfield-bfg-score
#5
Neil J Greening, Paul Vaughan, Inger Oey, Michael C Steiner, Mike D Morgan, Sridhar Rathinam, David A Waller
Lung volume reduction surgery (LVRS) has been shown to be beneficial in patients with chronic obstructive pulmonary disease, but there is low uptake, partly due to perceived concerns of high operative mortality. We aimed to develop an individualised risk score following LVRS.This was a cohort study of patients undergoing LVRS. Factors independently predicting 90-day mortality and a risk prediction score were identified. Reliability of the score was tested using area under the receiver operating characteristic curve (AUROC)...
June 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28446973/bronchoscopic-valves-for-prolonged-air-leak-current-status-and-technique
#6
REVIEW
Amit K Mahajan, Sandeep J Khandhar
Unidirectional airway valves are devices used for the treatment of persistent air leaks (PALs) secondary to alveolar-pleural fistulas (APF) or bronchopleural fistulas (BPFs). These valves were originally developed as a non-surgical alternative to lung volume reduction surgery (LVRS) for patients with chronic obstructive pulmonary disease (COPD). Randomized trials investigating the use of valves for bronchoscopic LVRS did not lead to the Federal Drug Administration (FDA) approval, but stemming from these studies a Humanitarian Device Exemption (HDE) was granted to Spiration intrabronchial valves (IBVs) for the treatment of PALs...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28373884/lung-volume-reduction-following-recurrent-pneumonia-an-unusual-finding-in-a-copd-patient
#7
Yihenew Negatu, Philip T Diaz
Chronic Obstructive Pulmonary Disease (COPD) is a progressive disease. Frequent pneumonias and exacerbations are known to accelerate its progression. We present a case of severe emphysema whose lung function paradoxically improved following recurrent pneumonia, without lung volume reduction surgery (LVRS). A 54-year-old female with severe COPD presented for LVRS evaluation. She was not a candidate for the surgery because of the unsuitable anatomic distribution of her emphysema. The patient experienced recurrent pneumonia over the years but her lung function and oxygen requirement showed marked improvement...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28182686/predicting-structure-function-relations-and-survival-following-surgical-and-bronchoscopic-lung-volume-reduction-treatment-of-emphysema
#8
Jarred R Mondoñedo, Béla Suki
Lung volume reduction surgery (LVRS) and bronchoscopic lung volume reduction (bLVR) are palliative treatments aimed at reducing hyperinflation in advanced emphysema. Previous work has evaluated functional improvements and survival advantage for these techniques, although their effects on the micromechanical environment in the lung have yet to be determined. Here, we introduce a computational model to simulate a force-based destruction of elastic networks representing emphysema progression, which we use to track the response to lung volume reduction via LVRS and bLVR...
February 2017: PLoS Computational Biology
https://www.readbyqxmd.com/read/28081287/current-insights-into-the-aetiology-pathobiology-and-management-of-local-disease-recurrence-in-squamous-cell-carcinoma-of-the-vulva
#9
REVIEW
Jkw Yap, D O'Neill, S Nagenthiran, C W Dawson, D M Luesley
Squamous cell carcinoma of the vulva is predominantly a disease of the elderly, where the mainstay of treatment is radical surgery. Local vulval recurrence (LVR) is a significant problem for these patients, and the rates of recurrence have not improved over the last three decades. Disappointingly, we still lack an understanding of how LVRs develop, and the best approach to prevent and manage the condition. This review discusses recent insights into the key prognostic factors that influence the risk of recurrence, focusing on the role of tumour-adjacent non-neoplastic epithelial disorders, which are thought to play a causative role...
January 12, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27882084/staged-bilateral-single-port-thoracoscopic-lung-volume-reduction-surgery-a-report-of-11-cases
#10
Miao Zhang, Heng Wang, Xue-Feng Pan, Wen-Bin Wu, Hui Zhang
The aim of the present study was to investigate the feasibility and efficacy of staged bilateral single-port thoracoscopic lung volume reduction surgery (LVRS) for patients with chronic obstructive pulmonary emphysema (COPE). Eleven male patients with a mean age of 60.27±12.11 years with bilateral COPE and bullae were admitted to the Department of Thoracic Surgery, Xuzhou Central Hospital from January 2013 to June 2014. The patients underwent staged bilateral single-port thoracoscopic LVRS. The hyperinflated bullae were resected using endoscopic staplers (Endo-GIA), followed by continuous suture and biological glue for reinforcement of the margin...
November 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27789728/is-preoperative-hypercapnia-a-justified-exclusion-criterion-for-lung-volume-reduction-surgery
#11
REVIEW
Priyadharshanan Ariyaratnam, Peter Tcherveniakov, Richard Milton, Nilanjan Chaudhuri
A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was whether potential surgical candidates for lung volume reduction surgery (LVRS), who have preoperative hypercapnia, should be excluded on this basis. Using the reported search, 45 papers were found, of which 14 represented the best evidence to answer the clinical question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses were tabulated...
February 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27745950/infants-with-low-vaccine-antibody-responses-have-altered-innate-cytokine-response
#12
Naveen Surendran, Ted Nicolosi, Michael Pichichero
We recently identified a population of 10% of infants who respond with sub-protective antibody levels to most routine primary pediatric vaccinations due to altered innate and adaptive immune responses. We term these infants as low vaccine responders (LVRs). Here we report new data showing that TLR7/8 agonist - R848 stimulation of PBMCs of LVR infants elicit significantly lower IFN-α, IL-12p70 and IL-1β, while inducing higher levels of CCL5 (RANTES) compared to normal vaccine responder (NVR) infants.
November 11, 2016: Vaccine
https://www.readbyqxmd.com/read/27739074/lung-volume-reduction-surgery-for-diffuse-emphysema
#13
REVIEW
Joseph Em van Agteren, Kristin V Carson, Leong Ung Tiong, Brian J Smith
BACKGROUND: Lung volume reduction surgery (LVRS) performed to treat patients with severe diffuse emphysema was reintroduced in the nineties. Lung volume reduction surgery aims to resect damaged emphysematous lung tissue, thereby increasing elastic properties of the lung. This treatment is hypothesised to improve long-term daily functioning and quality of life, although it may be costly and may be associated with risks of morbidity and mortality. Ten years have passed since the last version of this review was prepared, prompting us to perform an update...
October 14, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27607886/-lung-volume-reduction-surgery-state-of-the-art-2016
#14
REVIEW
C Caviezel, D Franzen, I Inci, W Weder
In a number of large case series in the mid-1990s, lung volume reduction surgery (LVRS) was shown to reduce dyspnoea and improve pulmonary function and quality of life in patients with advanced pulmonary emphysema. The large randomised National Emphysema Treatment Trial (NETT) confirmed this in the early 2000s and also demonstrated that selected patients live longer after surgery. Patient selection is crucial to the success of the procedure and should be performed at a specialised experienced centre with a multidisciplinary team approach on emphysema treatment...
September 2016: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/27594047/status-of-and-prospects-for-bronchoscopic-lung-volume-reduction-for-patients-with-severe-emphysema
#15
Hang Yu, Lijie Wang, Zhen Wu, Zhen Yang
Bronchoscopic lung volume reduction (BLVR) is a minimally invasive treatment for severe emphysema, providing treatment options for patients who are unable to undergo lung volume reduction surgery (LVRS) or lung transplantation. Current BLVR techniques include bronchoscopic volume reduction with valve implants, use of a lung volume reduction coil (LVRC), bronchoscopic thermal vapor ablation (BTVA), biological lung volume reduction (BioLVR), and use of airway bypass stents (ABS). To date, several randomized controlled trials of these bronchoscopic therapies have been conducted in patients with emphysema, and bronchoscopic volume reduction with valve implants remains the best approach thus far...
November 15, 2016: Bioscience Trends
https://www.readbyqxmd.com/read/27465095/single-site-cannulation-veno-venous-extracorporeal-co2-removal-as-bridge-to-lung-volume-reduction-surgery-in-end-stage-lung-emphysema
#16
Bassam Redwan, Stephan Ziegeler, Michael Semik, Joachim Fichter, Nicolas Dickgreber, Volker Vieth, Erik Christian Ernst, Stefan Fischer
Lung volume reduction surgery (LVRS) is an important treatment option for end-stage lung emphysema in carefully selected patients. Here, we first describe the application of low-flow v-v extracorporeal CO2 removal (LFVV-ECCO2R) as bridge to LVRS in patients with end-stage lung emphysema experiencing severe hypercapnia due to acute failure of the breathing pump.Between March and October 2015, n = 4 patients received single-site LFVV-ECCO2R as bridge to LVRS.Indication for ECLS was severe hypercapnia with respiratory acidosis and acute breathing pump failure...
July 26, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27445557/update-on-nonsurgical-lung-volume-reduction-procedures
#17
REVIEW
J Alberto Neder, Denis E O'Donnell
There has been a surge of interest in endoscopic lung volume reduction (ELVR) strategies for advanced COPD. Valve implants, coil implants, biological LVR (BioLVR), bronchial thermal vapour ablation, and airway stents are used to induce lung deflation with the ultimate goal of improving respiratory mechanics and chronic dyspnea. Patients presenting with severe air trapping (e.g., inspiratory capacity/total lung capacity (TLC) < 25%, residual volume > 225% predicted) and thoracic hyperinflation (TLC > 150% predicted) have the greatest potential to derive benefit from ELVR procedures...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/27444695/-what-place-for-lung-volume-reduction-surgery-for-emphysema
#18
REVIEW
J De Wolf, P Bonnette, É Sage, A Hamid
Lung volume reduction surgery (LVRS) has been part of the management for the treatment of selected emphysematous patients for two decades. In a large randomized American trial (NETT), lung volume reduction surgery was shown to improve overall survival at 5 years as well as exercise capacity and health-related quality of life, especially in cases of upper-lobe-predominant emphysema and low exercise capacity. Inclusion criteria were pretreatment FEV1≤45 %, TLC≥100 %, RV≥150 %, room air resting PaCO2≤60mmHg and PaO2≥45mmHg...
February 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/27427120/emphysema-coiling-up-the-lungs-trick-or-treat
#19
REVIEW
M Bezzi, M Mondoni, C Sorino, P Solidoro
Lung volume reduction coil (LVRC) treatment is a minimally-invasive technique planned to achieve an improvement of exercise capacity and pulmonary function in subjects with advanced emphysema and hyperinflation. It has been proposed together with other bronchoscopic lung volume reduction approaches to reduce lung hyperinflation in emphysema as less invasive alternatives to LVRS and are currently under clinical investigation. Following the successful early experiences in previous pilot trials, recent studies allow further investigation into the feasibility, safety and efficacy of LVR coil treatment in a multi-center setting in a larger group of patients...
August 2015: Minerva Medica
https://www.readbyqxmd.com/read/27332504/the-6-minute-walk-distance-test-as-a-chronic-obstructive-pulmonary-disease-stratification-tool-insights-from-the-copd-biomarker-qualification-consortium
#20
Bartolome Celli, Kay Tetzlaff, Gerard Criner, Michael I Polkey, Frank Sciurba, Richard Casaburi, Ruth Tal-Singer, Ariane Kawata, Debora Merrill, Stephen Rennard
RATIONALE: The 6-minute-walk distance (6MWD) test predicts mortality in chronic obstructive pulmonary disease (COPD). Whether variability in study type (observational vs. interventional) or region performed limits use of the test as a stratification tool or outcome measure for therapeutic trials is unclear. OBJECTIVES: To analyze the original data from several large observational studies and from randomized clinical trials with bronchodilators to support the qualification of the 6MWD test as a drug development tool in COPD...
December 15, 2016: American Journal of Respiratory and Critical Care Medicine
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