FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2019020171> ?p ?o ?g. }

• W2019020171 endingPage "363" @default.
• W2019020171 startingPage "361" @default.
• W2019020171 abstract "It has been over 12 years since Wakabayashi and colleagues1Wakabayashi A Brenner M Kayaleh RA et al.Thoracoscopic carbon dioxide laser treatment of bullous emphysema.Lancet. 1991; 337: 881-883Abstract PubMed Scopus (171) Google Scholar reported preliminary beneficial results using laser-induced lung volume shrinkage via unilateral thoracoscopy while attempting to improve functional capacity in patients with severe emphysema, and over 8 years since Cooper and coworkers2Cooper JD Trulock EP Triantafillou AN et al.Bilateral pneumectomy (volume reduction) for chronic obstructive pulmonary disease.J Thorac Cardiovasc Surg. 1995; 109: 106-116Abstract Full Text Full Text PDF PubMed Scopus (891) Google Scholar reported dramatic improvement in the lung function of such patients by surgically reducing lung volume bilaterally in emphysema patients with predominantly upper lobe disease, using stapling devices via sternotomy. This approach represented a modification of the original surgical concept by Brantigan and Mueller,3Brantigan O Mueller E Surgical treatment of pulmonary emphysema.Am Surg. 1957; 23: 789-804PubMed Google Scholar who performed surgical lung volume reduction surgery (LVRS) via bilateral thoracotomies in emphysematous patients almost 50 years ago. Although most reported trials agree in the concept that well-selected patients with severe emphysema derive benefit from LVRS, producing improvement in pulmonary function,4Flaherty KR Martinez FJ Lung volume reduction surgery for emphysema.Clin Chest Med. 2000; 21: 819-848Abstract Full Text Full Text PDF PubMed Scopus (39) Google Scholar exercise capacity,5Keller CA Ruppel G Hibbet A et al.Thoracoscopic lung volume reduction surgery reduces dyspnea and improves exercise capacity in patients with emphysema.Am J Respir Crit Care Med. 1997; 56: 60-67Crossref Scopus (71) Google Scholar6Benditt JO Lewis S Wood DE et al.Lung volume reduction surgery improves maximal O2comsumption, maximal minute ventilation, O2pulse and dead space to tidal volume ratios during leg cycle ergometry.Am J Respir Crit Care Med. 1997; 156: 561-566Crossref PubMed Scopus (84) Google Scholar and quality of life,7Cordova F O'Brien G Furukawa S et al.Stability of improvement in exercise performance and quality of life following bilateral lung volume reduction surgery in severe COPD.Chest. 1997; 112: 907-908Abstract Full Text Full Text PDF PubMed Scopus (84) Google Scholar there has been considerable debate throughout this time regarding the optimal surgical approach to achieve this end. In most reported surgical outcomes from patients undergoing LVRS, prolonged air leaks are the most common complication. Several facts were learned about LVRS from various clinical trials. It was shown that surgical LVRS (by sternotomy or thoracoscopy), using stapling devices for the resection of diseased portions of the lung, was superior to laser therapy, having less incidence of air leaks and superior functional benefit.8McKenna RJ Brenner M Gelb AF et al.A randomized, prospective trial of stapled lung reduction versus laser bullectomy for diffuse emphysema.J Thorac Cardiovasc Surg. 1996; 111: 1331-1338Abstract Full Text Full Text PDF Google Scholar It was also shown that bilateral LVRS in one surgical stage was preferable to sequential unilateral LVRS through two separate surgical events.9Hazelrigg SR Boley TM Magee MJ et al.Comparision of staged thoracoscopy and median sternotomy for lung volume reduction surgery.Ann Thorac Surg. 1998; 66: 1134-1139Abstract Full Text Full Text PDF PubMed Scopus (40) Google Scholar10Lowdermilk GA Keenan RJ Landreneau RJ et al.Comparison of clinical results for unilateral and bilateral thoracoscopic lung volume reduction.Ann Thorac Surg. 2000; 69: 1670-1674Abstract Full Text Full Text PDF PubMed Scopus (46) Google Scholar It also has been shown that the careful selection of patients is crucial to avoid disaster and to enhance favorable outcomes. Published results from the National Emphysema Treatment Trial (NETT) established several important points. Patients with very low FEV1 (ie, < 20% predicted), with very low carbon monoxide diffusion capacity (ie, < 20% predicted), and with evidence of homogeneously distributed emphysema by CT scanning have excessive 1-month and 6-month mortality rates (25% and 35%, respectively) when undergoing surgery.11National Emphysema Treatment Trial Research Group Patients at high risk of death after lung volume reduction surgery.N Engl J Med. 2001; 345: 1075-1083Crossref PubMed Scopus (595) Google Scholar The health-related quality of life for these subjects either did not change, decreased, or ended in death in this subgroup of patients. Therefore, they should not undergo LVRS. In reported data derived from 1,218 patients with severe emphysema, randomized through the NETT study, 580 received surgery, 406 by median sternotomy and 174 via bilateral video-assisted thoracoscopy.12National Emphysema Treatment Trial Research Group A randomized trial comparing lung volume reduction surgery with medical therapy for severe emphysema.N Engl J Med. 2003; 348: 2059-2073Crossref PubMed Scopus (1671) Google Scholar The 90-day mortality rate was 7.9% in the surgical group. There was no advantage in survival comparing sternotomy to thoracoscopy. The same study defined a subgroup of these patients who had the best outcomes after undergoing surgery. Patients were characterized by a heterogeneous type of emphysema and by predominant disease in both upper lobes, with low baseline exercise capacity (defined as tolerance for < 10 W of workload in a bicycle ergometer for women, and < 40 W for men). These patients derived significantly better survival rates than medically treated subjects, and they showed significant improvement in exercise capacity and better quality-of-life scores compared to medically treated patients. The NETT study has thus defined which patients should avoid LVRS and which patients are most likely to benefit from such a procedure. The surgical approach (sternotomy vs thoracoscopy) probably should be decided by the preference and expertise of the surgeon. For those patients undergoing LVRS, the morbidity derived from persistent air leaks following surgery continues to be the most common postoperative complication. Recently, Ciccone and collaborators13Ciccone AM Meyers BF Guthrie TJ et al.Long term outcome of bilateral lung volume reduction in 250 consecutive patients with emphysema.J Thorac Cardiovasc Surg. 2003; 125: 513-525Abstract Full Text Full Text PDF PubMed Scopus (162) Google Scholar reported the results of the long-term outcome of LVRS in 250 consecutive patients who were observed for up to 5 years. Prolonged air leaks were the most common surgical complication in their series, with 45% of patients (113 patients) having persistent air leaks for > 7 days, and 8 patients requiring surgical reexploration. Throughout the history of LVRS, multiple surgical manipulations have been reported to reduce the incidence or length of time of air leaks. Buttressing the staple line with bovine pericardium has been one of the most popular variations in surgical technique.14Stammberger U Klepetko W Stamatis G et al.Buttressing the staple line in lung volume reduction surgery: a randomized three center study.Ann Thorac Surg. 2000; 70: 1820-1825Abstract Full Text Full Text PDF PubMed Scopus (92) Google Scholar15Toloza EM Harpole DH Intraoperative technique to prevent air leaks.Chest Surg Clin N Am. 2002; 12: 489-505Abstract Full Text Full Text PDF PubMed Scopus (24) Google Scholar16Murray KD Ho CH Hsia JY The influence of pulmonary staple line reinforcement on air leaks.Chest. 2002; 122: 2146-2159Abstract Full Text Full Text PDF PubMed Scopus (58) Google Scholar Other authors have used talc poudrage,17Cerfolio RJ Tummala RP Holman WL et al.A prospective algorithm for the management of air leaks after pulmonary resection.Ann Thorac Surg. 1998; 66: 1726-1731Abstract Full Text Full Text PDF PubMed Scopus (148) Google Scholar the application of various kinds of glues and sealants,18Wain JC Kaisel LR Johnstone DW et al.Trial of a novel synthetic sealant in preventing air leaks after lung resection.Ann Thorac Surg. 2001; 71: 1623-1628Abstract Full Text Full Text PDF PubMed Scopus (139) Google Scholar19Porte HL Jany T Akkad R et al.Randomized controlled trial of a synthetic sealant for preventing alveolar air leaks after lobectomy.Ann Thorac Surg. 2001; 71: 1618-1622Abstract Full Text Full Text PDF PubMed Scopus (86) Google Scholar and even the creation of pleural tents to cover the staple lines,20Brunelli A Al Refai M Monteverde M et al.Pleural tent after upper lobectomy: a randomized study of efficacy and duration of effect.Ann Thorac Surg. 2002; 74: 1958-1962Abstract Full Text Full Text PDF PubMed Scopus (59) Google Scholar all of which are reflections of the frustrating fact that it is hard to place air-tight sutures in lung tissue destroyed by emphysema. When air leaks are persistent, surgical reexploration can be attempted, although it is rarely successful, or patients are discharged home with Heimlich valve devices to allow the closure of air leaks after prolonged observation.21Cerfolio RJ Bass CS Pask AH et al.Predictors and treatment of persistent air leaks.Ann Thorac Surg. 2002; 73: 1727-1730Abstract Full Text Full Text PDF PubMed Scopus (182) Google Scholar Large air leaks can be further complicated by massive subcutaneous emphysema and, in some cases, by respiratory failure. In this issue of CHEST (see page 633), a new approach is proposed by Steven Mink and coworkers. They describe an innovative surgical system that allows rapid resection of emphysematous tissue to produce effective surgical lung volume reduction, while avoiding the occurrence of air leaks. The authors created an elegant emphysema model in 14 dogs undergoing multiple intrabronchial administration of papain, until the total lung capacity of these animals increased to 125% of baseline and functional residual capacity increased to 150% from baseline. The dogs developed marked decreases in flow rates. Seven of these dogs underwent LVRS via sternotomy, and seven were used as controls. To resect lung tissue, Mink et al used a prototype of a novel vacuum-assisted lung capture and reinforcement system (VALR Surgical System; Spiration Inc; Redmond, WA). This device consists of an implantable soft silicone cylindrical sleeve loaded inside a larger and rigid cylindrical introducer with an adapter to apply suction on its distal end. The vacuum is used to suction and drag the targeted lung tissue into the soft inner cylindrical sleeve. Once deployed, the radial traction of the silicone sleeve compresses lung tissue, producing volume reduction. Once the targeted lung is captured, the rigid cylinder is released and the soft compression sleeve with the lung tissue captured inside prevents the reexpansion of the lung tissue. The proximal section of this sleeve is sutured using U-stitches, and the sleeve is resected above the suture line. In most cases, they used one silicone sleeve to reduce the right upper lobe, and two sleeves to reduce the left upper lobe. They observed no air leaks in any of the surgically treated dogs. Chest tubes were removed within 4 h in all animals. Follow-up of pulmonary function revealed a significant reduction in total lung capacity, functional residual capacity, and residual volume among surgically treated dogs compared to controls. Likewise, significant improvements in pressure-volume curves and expiratory flows following lung reduction occurred at 1 and 6 months among surgically treated dogs compared with controls. The animals were killed after the 6-month evaluation. In most animals that undergo surgery, the implanted devices were found in place covered by a thin fibrotic encapsulation limited to the silicone material, with the lung tissue inside the device appearing fibrotic and contracted within the device. Migration of the device was observed in two instances. Histologically, the tissue within the devices showed coagulative necrosis and chronic inflammation. Fibrotic encapsulation of the devices was described as being complete, with minimal extension to lung or pleura. In two of the seven animals operated on, there was histologic evidence of pyogranulomatous inflammation in the area associated with the devices, and cultures of such areas grew Pseudomonas aeruginosa, without evidence of infection in the surrounding nonreduced lung tissue. The future of LVRS as a therapeutic alternative for emphysema patients in the United States is still undecided. Although the process of patient selection has been refined and the target population that may derive significant benefit from this technique has been clearly defined by the NETT trial, it remains to be seen whether this is a procedure that will be covered by Medicare and major insurance companies. If this procedure continues to be offered to selected emphysema patients, then the use of a device like the one proposed by Mink et al will likely find a place in the armamentarium of the thoracic surgeons performing these procedures. Larger animal studies will be required to define better the role of possible infection in the small portions of lung tissue captured within the piece of silicone cylinder that remains attached to the surgical site, and controlled randomized human trials will be required to show that this device or a variation of it can indeed be technically used in human lungs with advanced emphysema, which will pose new challenges. The anatomic characteristics of the human chest cage may pose limitations to the use of a large and rigid device that can be used more easily in the more flexible canine thorax. Likewise, human cases of emphysema frequently are associated with other complicating factors, such as pleural thickening and fibrosis, scarring, and presence of small nodules. These factors may pose a different resistance for this tissue to be captured within a silicone sleeve compared to the clean papain-created model. Nevertheless, this is a novel idea to approach and resolve a frustrating problem that commonly complicates the outcomes of emphysema patients who undergo LVRS." @default.
• W2019020171 created "2016-06-24" @default.
• W2019020171 creator A5042896960 @default.
• W2019020171 date "2004-02-01" @default.
• W2019020171 modified "2023-10-18" @default.
• W2019020171 title "Lasers, Staples, Bovine Pericardium, Talc, Glue and… Suction Cylinders?" @default.
• W2019020171 cites W1981894764 @default.
• W2019020171 cites W1982883445 @default.
• W2019020171 cites W1985969785 @default.
• W2019020171 cites W2017162787 @default.
• W2019020171 cites W2022089704 @default.
• W2019020171 cites W2022889830 @default.
• W2019020171 cites W2026217381 @default.
• W2019020171 cites W2026719485 @default.
• W2019020171 cites W2028878782 @default.
• W2019020171 cites W2068040633 @default.
• W2019020171 cites W2073355716 @default.
• W2019020171 cites W2097448864 @default.
• W2019020171 cites W2101787490 @default.
• W2019020171 cites W2111176071 @default.
• W2019020171 cites W2113191321 @default.
• W2019020171 cites W2119348698 @default.
• W2019020171 cites W2123950352 @default.
• W2019020171 cites W2141033581 @default.
• W2019020171 cites W2154615134 @default.
• W2019020171 cites W2155197146 @default.
• W2019020171 cites W2605650619 @default.
• W2019020171 cites W2415113762 @default.
• W2019020171 doi "https://doi.org/10.1378/chest.125.2.361" @default.
• W2019020171 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/14769708" @default.
• W2019020171 hasPublicationYear "2004" @default.
• W2019020171 type Work @default.
• W2019020171 sameAs 2019020171 @default.
• W2019020171 citedByCount "7" @default.
• W2019020171 countsByYear W20190201712014 @default.
• W2019020171 countsByYear W20190201712015 @default.
• W2019020171 countsByYear W20190201712016 @default.
• W2019020171 countsByYear W20190201712020 @default.
• W2019020171 crossrefType "journal-article" @default.
• W2019020171 hasAuthorship W2019020171A5042896960 @default.
• W2019020171 hasBestOaLocation W20190201711 @default.
• W2019020171 hasConcept C105702510 @default.
• W2019020171 hasConcept C127413603 @default.
• W2019020171 hasConcept C141071460 @default.
• W2019020171 hasConcept C159985019 @default.
• W2019020171 hasConcept C192562407 @default.
• W2019020171 hasConcept C23795335 @default.
• W2019020171 hasConcept C2778875491 @default.
• W2019020171 hasConcept C2779937294 @default.
• W2019020171 hasConcept C2779979586 @default.
• W2019020171 hasConcept C71924100 @default.
• W2019020171 hasConcept C78519656 @default.
• W2019020171 hasConceptScore W2019020171C105702510 @default.
• W2019020171 hasConceptScore W2019020171C127413603 @default.
• W2019020171 hasConceptScore W2019020171C141071460 @default.
• W2019020171 hasConceptScore W2019020171C159985019 @default.
• W2019020171 hasConceptScore W2019020171C192562407 @default.
• W2019020171 hasConceptScore W2019020171C23795335 @default.
• W2019020171 hasConceptScore W2019020171C2778875491 @default.
• W2019020171 hasConceptScore W2019020171C2779937294 @default.
• W2019020171 hasConceptScore W2019020171C2779979586 @default.
• W2019020171 hasConceptScore W2019020171C71924100 @default.
• W2019020171 hasConceptScore W2019020171C78519656 @default.
• W2019020171 hasIssue "2" @default.
• W2019020171 hasLocation W20190201711 @default.
• W2019020171 hasLocation W20190201712 @default.
• W2019020171 hasOpenAccess W2019020171 @default.
• W2019020171 hasPrimaryLocation W20190201711 @default.
• W2019020171 hasRelatedWork W2002120878 @default.
• W2019020171 hasRelatedWork W2003938723 @default.
• W2019020171 hasRelatedWork W2019020171 @default.
• W2019020171 hasRelatedWork W2047967234 @default.
• W2019020171 hasRelatedWork W2057536996 @default.
• W2019020171 hasRelatedWork W2118496982 @default.
• W2019020171 hasRelatedWork W2439875401 @default.
• W2019020171 hasRelatedWork W4238867864 @default.
• W2019020171 hasRelatedWork W2519357708 @default.
• W2019020171 hasRelatedWork W2525756941 @default.
• W2019020171 hasVolume "125" @default.
• W2019020171 isParatext "false" @default.
• W2019020171 isRetracted "false" @default.
• W2019020171 magId "2019020171" @default.
• W2019020171 workType "article" @default.