Bostancı Korkut, Bilgi Zeynep, Ömercikoğlu Hakan, Çetinkaya Çağatay, Olgun Yıldızeli Şehnaz, Yüksel Mustafa, Stamenovic Davor
Department of Thoracic Surgery, Marmara University Faculty of Medicine, İstanbul, Turkey.
Department of Chest Diseases, Marmara University Faculty of Medicine, İstanbul, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2019 Jan 1;27(1):57-62. doi: 10.5606/tgkdc.dergisi.2019.16893. eCollection 2019 Jan.
This study aims to present our experience with endobronchial coils in patients who underwent endobronchial lung volume reduction due to advanced emphysema.
The study included 46 patients (45 males, 1 female; mean age 61.7±8 years; range, 43 to 80 years) who underwent endobronchial lung volume reduction with endobronchial coils for advanced emphysema. Patients" age, gender, pulmonary function tests, post-treatment morbidity, mortality, pre- and post-treatment (6 months) six-minute walking distance, modified Medical Research Council dyspnea scores, chronic obstructive pulmonary disease assessment test and Hospital Anxiety and Depression Scale scores were recorded.
Patients had an average of 65 pack/year smoking history. An average of 11 (range, 9-15) coils were placed per lobe (right upper lobe=35, left upper lobe=19, right lower lobe=2, left lower lobe=4). Mean follow-up duration was 12.6 months (±5.6 months). Post-treatment forced expiratory volume in one second, residual volume and six-minute walking distance values were improved with statistical significance. Also, significant improvement was seen in quality of life, quantified by modified Medical Research Council, chronic obstructive pulmonary disease assessment test and Hospital Anxiety and Depression Scale scores. While no immediate major postoperative complications occurred, three patients developed chronic obstructive pulmonary disease exacerbation, two developed pneumonia, and one developed recurrence of previous neurologic disorder within 30 days.
Endobronchial coil administration provides lower morbidity and mortality compared to lung volume reduction surgery as well as significant improvement in pulmonary functions and quality of life in selected patients with advanced emphysema.
本研究旨在介绍我们在因晚期肺气肿接受支气管内肺减容术的患者中使用支气管内线圈的经验。
该研究纳入了46例（45例男性，1例女性；平均年龄61.7±8岁；范围43至80岁）因晚期肺气肿接受支气管内线圈支气管内肺减容术的患者。记录患者的年龄、性别、肺功能测试、治疗后发病率、死亡率、治疗前和治疗后（6个月）的六分钟步行距离、改良医学研究委员会呼吸困难评分、慢性阻塞性肺疾病评估测试以及医院焦虑抑郁量表评分。
患者平均吸烟史为65包/年。每叶平均放置11个（范围9 - 15个）线圈（右上叶 = 35个，左上叶 = 19个，右下叶 = 2个，左下叶 = 4个）。平均随访时间为12.6个月（±5.6个月）。治疗后一秒用力呼气量、残气量和六分钟步行距离值有统计学意义的改善。此外，通过改良医学研究委员会、慢性阻塞性肺疾病评估测试和医院焦虑抑郁量表评分量化的生活质量也有显著改善。虽然术后未立即发生重大并发症，但3例患者在30天内出现慢性阻塞性肺疾病加重，2例发生肺炎，1例既往神经系统疾病复发。
与肺减容手术相比，支气管内线圈给药的发病率和死亡率更低，并且在选定的晚期肺气肿患者中，肺功能和生活质量有显著改善。
