Faculty Collaboration Database

Efficacy of bronchoscopic lung volume reduction: a meta-analysis. Int J Chron Obstruct Pulmon Dis 2014;9:481-91

Date

05/29/2014

Pubmed ID

24868153

Pubmed Central ID

PMC4027920

DOI

10.2147/COPD.S63378

Scopus ID

2-s2.0-84900791244 (requires institutional sign-in at Scopus site)   20 Citations

Abstract

BACKGROUND: Over the last several years, the morbidity, mortality, and high costs associated with lung volume reduction (LVR) surgery has fuelled the development of different methods for bronchoscopic LVR (BLVR) in patients with emphysema. In this meta-analysis, we sought to study and compare the efficacy of most of these methods.

METHODS: ELIGIBLE STUDIES WERE RETRIEVED FROM PUBMED AND EMBASE FOR THE FOLLOWING BLVR METHODS: one-way valves, sealants (BioLVR), LVR coils, airway bypass stents, and bronchial thermal vapor ablation. Primary study outcomes included the mean change post-intervention in the lung function tests, the 6-minute walk distance, and the St George's Respiratory Questionnaire. Secondary outcomes included treatment-related complications.

RESULTS: Except for the airway bypass stents, all other methods of BLVR showed efficacy in primary outcomes. However, in comparison, the BioLVR method showed the most significant findings and was the least associated with major treatment-related complications. For the BioLVR method, the mean change in forced expiratory volume (in first second) was 0.18 L (95% confidence interval [CI]: 0.09 to 0.26; P<0.001); in 6-minute walk distance was 23.98 m (95% CI: 12.08 to 35.88; P<0.01); and in St George's Respiratory Questionnaire was -8.88 points (95% CI: -12.12 to -5.64; P<0.001).

CONCLUSION: The preliminary findings of our meta-analysis signify the importance of most methods of BLVR. The magnitude of the effect on selected primary outcomes shows noninferiority, if not equivalence, when compared to what is known for surgical LVR.

Author List

Iftikhar IH, McGuire FR, Musani AI

MESH terms used to index this publication - Major topics in bold

Bronchoscopy
Exercise Therapy
Exercise Tolerance
Forced Expiratory Volume
Humans
Lung
Lung Volume Measurements
Pneumonectomy
Pulmonary Disease, Chronic Obstructive
Pulmonary Emphysema
Recovery of Function
Stents
Surveys and Questionnaires
Time Factors
Treatment Outcome
Walking