Utility of Functional Pneumonectomy by Using Intrabronchial Valves: First Case Series and Single Center Experience.

Area of Science:

• Pulmonology
• Thoracic Surgery
• Interventional Pulmonology

Background:

• Intrabronchial valves are FDA-approved for lung volume reduction in COPD and for managing prolonged air leaks.
• Limited data exists on the efficacy of bronchoscopic functional pneumonectomy (BFP) for persistent air leak (PAL) or lung volume reduction.

Purpose of the Study:

• To evaluate the safety and efficacy of BFP in patients with PAL or for lung volume reduction.
• To assess BFP as a minimally invasive management option for challenging PAL cases.

Main Methods:

• An observational study involving 10 consecutive patients who underwent BFP for PAL or lung volume reduction after failing traditional therapies.
• 17 valve placement procedures were performed, with a median of 8 valves (range: 5-12) per patient.
• BFP was used in one lung transplant patient for native lung hyperinflation and in nine patients for spontaneous or postoperative PAL.

Main Results:

• All 9 patients with PAL achieved successful chest tube removal (median: 7 days).
• Pneumonia was the sole procedure-related complication, occurring in one patient.
• Valves were removed within 6 weeks post-chest tube removal in 6 patients.

Conclusions:

• Persistent air leak (PAL) is often associated with severe lung conditions or post-surgical complications and can be difficult to manage.
• Bronchoscopic functional pneumonectomy (BFP) presents a viable, minimally invasive treatment option for PAL.
• Further research is warranted to establish BFP's role in lung volume reduction and PAL management.