Background: The poor treatment outcomes of multidrug-resistant tuberculosis (TB) and the emergence of extensively drug-resistant TB and extremely and totally drug-resistant TB highlight the urgent need for new antituberculous drugs and other adjuvant treatment approaches. Objectives: We have treated cavitary tuberculosis by the application of endobronchial one-way valves (Zephyr (R); Pulmonx Inc., Redwood City, Calif., USA) to induce lobar volume reduction as an adjunct to drug treatment. This report describes the feasibility, effectiveness and safety of the procedure. Methods: Patients with severe lung destruction, one or more cavities or those who were ineligible for surgical resection and showed an unsatisfactory response to standard drug treatments were enrolled. During bronchoscopy, endobronchial valves were implanted in the lobar or segmental bronchi in order to induce atelectasis and reduce the cavity size. Results: Four TB patients and 1 patient with atypical mycobacteriosis were treated. The mean patient age was 52.6 years. Complete cavity collapses were observed on CT scans in 4 of the 5 cases. All patients showed improvements in their clinical status, and sputum smears became negative within 3-5 months. There were no severe short-or long-term complications. The valves were removed in 3 of the 5 patients after 8 months on average; there was no relapse after 15 months of follow-up. Conclusion: These data suggest that endobronchial valves are likely to be useful adjuncts to the treatment of therapeutically difficult patients. More data are required to confirm our findings. (C) 2016 S. Karger AG, Basel

Lobar collapse therapy using endobronchial valves as a new complementary approach to treat cavities in multidrug-resistant tuberculosis and difficult-to-treat tuberculosis: A case series / Corbetta, L; Tofani, A; Montinaro, F; Michieletto, L; Ceron, L; Moroni, C; Rogasi, Pg.. - In: RESPIRATION. - ISSN 0025-7931. - ELETTRONICO. - 92:(2016), pp. 316-328. [10.1159/000450757]

Lobar collapse therapy using endobronchial valves as a new complementary approach to treat cavities in multidrug-resistant tuberculosis and difficult-to-treat tuberculosis: A case series

CORBETTA, LORENZO;TOFANI, ARIELA;CERON, LORIS;MORONI, CHIARA;
2016

Abstract

Background: The poor treatment outcomes of multidrug-resistant tuberculosis (TB) and the emergence of extensively drug-resistant TB and extremely and totally drug-resistant TB highlight the urgent need for new antituberculous drugs and other adjuvant treatment approaches. Objectives: We have treated cavitary tuberculosis by the application of endobronchial one-way valves (Zephyr (R); Pulmonx Inc., Redwood City, Calif., USA) to induce lobar volume reduction as an adjunct to drug treatment. This report describes the feasibility, effectiveness and safety of the procedure. Methods: Patients with severe lung destruction, one or more cavities or those who were ineligible for surgical resection and showed an unsatisfactory response to standard drug treatments were enrolled. During bronchoscopy, endobronchial valves were implanted in the lobar or segmental bronchi in order to induce atelectasis and reduce the cavity size. Results: Four TB patients and 1 patient with atypical mycobacteriosis were treated. The mean patient age was 52.6 years. Complete cavity collapses were observed on CT scans in 4 of the 5 cases. All patients showed improvements in their clinical status, and sputum smears became negative within 3-5 months. There were no severe short-or long-term complications. The valves were removed in 3 of the 5 patients after 8 months on average; there was no relapse after 15 months of follow-up. Conclusion: These data suggest that endobronchial valves are likely to be useful adjuncts to the treatment of therapeutically difficult patients. More data are required to confirm our findings. (C) 2016 S. Karger AG, Basel
2016
92
316
328
Corbetta, L; Tofani, A; Montinaro, F; Michieletto, L; Ceron, L; Moroni, C; Rogasi, Pg.
File in questo prodotto:
File Dimensione Formato  
450757.pdf

accesso aperto

Tipologia: Versione finale referata (Postprint, Accepted manuscript)
Licenza: Open Access
Dimensione 677.31 kB
Formato Adobe PDF
677.31 kB Adobe PDF

I documenti in FLORE sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1096761
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 12
  • ???jsp.display-item.citation.isi??? 10
social impact