Intrabronchial Valves for Air Leaks After Lobectomy, Segmentectomy, and Lung Volume Reduction Surgery

Area of Science:

• Pulmonology
• Thoracic Surgery
• Medical Devices

Background:

• Post-operative air leaks are a frequent complication following lung surgeries like lobectomy, segmentectomy, and lung volume reduction surgery (LVRS).
• These air leaks increase patient morbidity, healthcare costs, and prolong hospital stays, highlighting the need for effective management strategies.
• Current management of post-pulmonary resection air leaks remains challenging, necessitating minimally invasive and effective interventions.

Purpose of the Study:

• To evaluate the feasibility and effectiveness of the Spiration Valve System (SVS) for managing prolonged air leaks after pulmonary resection.
• To assess the resolution rate and impact on hospital stay when using bronchoscopic SVS in patients with air leaks.

Main Methods:

• A prospective, multicenter registry study involving 39 patients with air leaks post-lobectomy, segmentectomy, or LVRS.
• The study employed an intention-to-treat approach, utilizing bronchoscopic placement of the Spiration Valve System (SVS).
• Data collected included SVS placement feasibility, number of valves placed, response to treatment, air leak resolution, and post-procedure hospital stay.

Main Results:

• Bronchoscopic SVS placement was feasible in 82.1% of patients (32/39), with a median of 2 valves per patient.
• A positive response to SVS placement was observed in 76.9% of all patients and 93.8% of those with feasible placement.
• Air leaks ultimately resolved in 87.5% of patients with feasible SVS placement, with a median resolution time of 2.5 days. The overall intention-to-treat analysis suggested SVS contributed to resolution in 71.8% of patients.
• The median post-procedure hospital stay was reduced to 4 days.

Conclusions:

• This prospective registry demonstrates that bronchoscopic placement of the Spiration Valve System is a feasible and effective option for managing air leaks after lung surgery.
• The SVS shows promise in resolving prolonged air leaks, potentially reducing morbidity and length of hospital stay.
• The findings support the growing evidence for the utility of one-way valves in the management of post-pulmonary resection air leaks.