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

Muhanned Abu-Hijleh, Kim Styrvoky, Vikram Anand, Fernando Woll, Lonny Yarmus, Michael S. Machuzak, Daniel A. Nader, Timothy W. Mullett, D. Kyle Hogarth, Jennifer Toth, Ghazwan Acash, Roberto F. Casal, Stephen Hazelrigg, Douglas E. Wood

Research output: Contribution to journalArticle

Abstract

Purpose: Air leaks are common after lobectomy, segmentectomy, and lung volume reduction surgery (LVRS). This can increase post-operative morbidity, cost, and hospital length of stay. The management of post-pulmonary resection air leaks remains challenging. Minimally invasive effective interventions are necessary. The Spiration Valve System (SVS, Olympus/Spiration Inc., Redmond, WA, US) is approved by the FDA under humanitarian use exemption for management of prolonged air leaks. Methods: This is a prospective multicenter registry of 39 patients with air leaks after lobectomy, segmentectomy, and LVRS managed with an intention to use bronchoscopic SVS to resolve air leaks. Results: Bronchoscopic SVS placement was feasible in 82.1% of patients (32/39 patients) and 90 valves were placed with a median of 2 valves per patient (mean of 2.7 ± 1.5 valves, range of 1 to 7 valves). Positive response to SVS placement was documented in 76.9% of all patients (30/39 patients) and in 93.8% of patients when SVS placement was feasible (30/32 patients). Air leaks ultimately resolved when SVS placement was feasible in 87.5% of patients (28/32 patients), after a median of 2.5 days (mean ± SD of 8.9 ± 12.4 days). Considering all patients with an intention to treat analysis, bronchoscopic SVS procedure likely contributed to resolution of air leaks in 71.8% of patients (28/39 patients). The post-procedure median hospital stay was 4 days (mean 6.0 ± 6.1 days). Conclusions: This prospective registry adds to the growing body of literature supporting feasible and effective management of air leaks utilizing one-way valves.

Original languageEnglish (US)
Pages (from-to)627-633
Number of pages7
JournalLung
Volume197
Issue number5
DOIs
StatePublished - Oct 1 2019

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Segmental Mastectomy
Pneumonectomy
Air
Length of Stay
Registries
Intention to Treat Analysis

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine

Cite this

Abu-Hijleh, M., Styrvoky, K., Anand, V., Woll, F., Yarmus, L., Machuzak, M. S., ... Wood, D. E. (2019). Intrabronchial Valves for Air Leaks After Lobectomy, Segmentectomy, and Lung Volume Reduction Surgery. Lung, 197(5), 627-633. https://doi.org/10.1007/s00408-019-00268-7
Abu-Hijleh, Muhanned ; Styrvoky, Kim ; Anand, Vikram ; Woll, Fernando ; Yarmus, Lonny ; Machuzak, Michael S. ; Nader, Daniel A. ; Mullett, Timothy W. ; Hogarth, D. Kyle ; Toth, Jennifer ; Acash, Ghazwan ; Casal, Roberto F. ; Hazelrigg, Stephen ; Wood, Douglas E. / Intrabronchial Valves for Air Leaks After Lobectomy, Segmentectomy, and Lung Volume Reduction Surgery. In: Lung. 2019 ; Vol. 197, No. 5. pp. 627-633.
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title = "Intrabronchial Valves for Air Leaks After Lobectomy, Segmentectomy, and Lung Volume Reduction Surgery",
abstract = "Purpose: Air leaks are common after lobectomy, segmentectomy, and lung volume reduction surgery (LVRS). This can increase post-operative morbidity, cost, and hospital length of stay. The management of post-pulmonary resection air leaks remains challenging. Minimally invasive effective interventions are necessary. The Spiration Valve System (SVS, Olympus/Spiration Inc., Redmond, WA, US) is approved by the FDA under humanitarian use exemption for management of prolonged air leaks. Methods: This is a prospective multicenter registry of 39 patients with air leaks after lobectomy, segmentectomy, and LVRS managed with an intention to use bronchoscopic SVS to resolve air leaks. Results: Bronchoscopic SVS placement was feasible in 82.1{\%} of patients (32/39 patients) and 90 valves were placed with a median of 2 valves per patient (mean of 2.7 ± 1.5 valves, range of 1 to 7 valves). Positive response to SVS placement was documented in 76.9{\%} of all patients (30/39 patients) and in 93.8{\%} of patients when SVS placement was feasible (30/32 patients). Air leaks ultimately resolved when SVS placement was feasible in 87.5{\%} of patients (28/32 patients), after a median of 2.5 days (mean ± SD of 8.9 ± 12.4 days). Considering all patients with an intention to treat analysis, bronchoscopic SVS procedure likely contributed to resolution of air leaks in 71.8{\%} of patients (28/39 patients). The post-procedure median hospital stay was 4 days (mean 6.0 ± 6.1 days). Conclusions: This prospective registry adds to the growing body of literature supporting feasible and effective management of air leaks utilizing one-way valves.",
author = "Muhanned Abu-Hijleh and Kim Styrvoky and Vikram Anand and Fernando Woll and Lonny Yarmus and Machuzak, {Michael S.} and Nader, {Daniel A.} and Mullett, {Timothy W.} and Hogarth, {D. Kyle} and Jennifer Toth and Ghazwan Acash and Casal, {Roberto F.} and Stephen Hazelrigg and Wood, {Douglas E.}",
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Abu-Hijleh, M, Styrvoky, K, Anand, V, Woll, F, Yarmus, L, Machuzak, MS, Nader, DA, Mullett, TW, Hogarth, DK, Toth, J, Acash, G, Casal, RF, Hazelrigg, S & Wood, DE 2019, 'Intrabronchial Valves for Air Leaks After Lobectomy, Segmentectomy, and Lung Volume Reduction Surgery', Lung, vol. 197, no. 5, pp. 627-633. https://doi.org/10.1007/s00408-019-00268-7

Intrabronchial Valves for Air Leaks After Lobectomy, Segmentectomy, and Lung Volume Reduction Surgery. / Abu-Hijleh, Muhanned; Styrvoky, Kim; Anand, Vikram; Woll, Fernando; Yarmus, Lonny; Machuzak, Michael S.; Nader, Daniel A.; Mullett, Timothy W.; Hogarth, D. Kyle; Toth, Jennifer; Acash, Ghazwan; Casal, Roberto F.; Hazelrigg, Stephen; Wood, Douglas E.

In: Lung, Vol. 197, No. 5, 01.10.2019, p. 627-633.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Intrabronchial Valves for Air Leaks After Lobectomy, Segmentectomy, and Lung Volume Reduction Surgery

AU - Abu-Hijleh, Muhanned

AU - Styrvoky, Kim

AU - Anand, Vikram

AU - Woll, Fernando

AU - Yarmus, Lonny

AU - Machuzak, Michael S.

AU - Nader, Daniel A.

AU - Mullett, Timothy W.

AU - Hogarth, D. Kyle

AU - Toth, Jennifer

AU - Acash, Ghazwan

AU - Casal, Roberto F.

AU - Hazelrigg, Stephen

AU - Wood, Douglas E.

PY - 2019/10/1

Y1 - 2019/10/1

N2 - Purpose: Air leaks are common after lobectomy, segmentectomy, and lung volume reduction surgery (LVRS). This can increase post-operative morbidity, cost, and hospital length of stay. The management of post-pulmonary resection air leaks remains challenging. Minimally invasive effective interventions are necessary. The Spiration Valve System (SVS, Olympus/Spiration Inc., Redmond, WA, US) is approved by the FDA under humanitarian use exemption for management of prolonged air leaks. Methods: This is a prospective multicenter registry of 39 patients with air leaks after lobectomy, segmentectomy, and LVRS managed with an intention to use bronchoscopic SVS to resolve air leaks. Results: Bronchoscopic SVS placement was feasible in 82.1% of patients (32/39 patients) and 90 valves were placed with a median of 2 valves per patient (mean of 2.7 ± 1.5 valves, range of 1 to 7 valves). Positive response to SVS placement was documented in 76.9% of all patients (30/39 patients) and in 93.8% of patients when SVS placement was feasible (30/32 patients). Air leaks ultimately resolved when SVS placement was feasible in 87.5% of patients (28/32 patients), after a median of 2.5 days (mean ± SD of 8.9 ± 12.4 days). Considering all patients with an intention to treat analysis, bronchoscopic SVS procedure likely contributed to resolution of air leaks in 71.8% of patients (28/39 patients). The post-procedure median hospital stay was 4 days (mean 6.0 ± 6.1 days). Conclusions: This prospective registry adds to the growing body of literature supporting feasible and effective management of air leaks utilizing one-way valves.

AB - Purpose: Air leaks are common after lobectomy, segmentectomy, and lung volume reduction surgery (LVRS). This can increase post-operative morbidity, cost, and hospital length of stay. The management of post-pulmonary resection air leaks remains challenging. Minimally invasive effective interventions are necessary. The Spiration Valve System (SVS, Olympus/Spiration Inc., Redmond, WA, US) is approved by the FDA under humanitarian use exemption for management of prolonged air leaks. Methods: This is a prospective multicenter registry of 39 patients with air leaks after lobectomy, segmentectomy, and LVRS managed with an intention to use bronchoscopic SVS to resolve air leaks. Results: Bronchoscopic SVS placement was feasible in 82.1% of patients (32/39 patients) and 90 valves were placed with a median of 2 valves per patient (mean of 2.7 ± 1.5 valves, range of 1 to 7 valves). Positive response to SVS placement was documented in 76.9% of all patients (30/39 patients) and in 93.8% of patients when SVS placement was feasible (30/32 patients). Air leaks ultimately resolved when SVS placement was feasible in 87.5% of patients (28/32 patients), after a median of 2.5 days (mean ± SD of 8.9 ± 12.4 days). Considering all patients with an intention to treat analysis, bronchoscopic SVS procedure likely contributed to resolution of air leaks in 71.8% of patients (28/39 patients). The post-procedure median hospital stay was 4 days (mean 6.0 ± 6.1 days). Conclusions: This prospective registry adds to the growing body of literature supporting feasible and effective management of air leaks utilizing one-way valves.

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Abu-Hijleh M, Styrvoky K, Anand V, Woll F, Yarmus L, Machuzak MS et al. Intrabronchial Valves for Air Leaks After Lobectomy, Segmentectomy, and Lung Volume Reduction Surgery. Lung. 2019 Oct 1;197(5):627-633. https://doi.org/10.1007/s00408-019-00268-7