International Journal of COPD (Aug 2022)

Bronchoscopic Treatment of Giant Emphysematous Bullae with Endobronchial Silicone Plugs

  • Lin H,
  • Zhang H,
  • Yang D,
  • Chen X,
  • Chen Y,
  • Song D,
  • Cai C,
  • Zeng Y

Journal volume & issue
Vol. Volume 17
pp. 1743 – 1750

Abstract

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Huihuang Lin,1,* Huaping Zhang,1,* Dongyong Yang,1,* Xiaoyang Chen,1,* Yunfeng Chen,1,* Duanhong Song,1 Chi Cai,2 Yiming Zeng1 1Department of Pulmonary and Critical Care Medicine, the Second Affiliated Hospital of Fujian Medical University, Center of Respiratory Medicine of Fujian Province, Quanzhou, People’s Republic of China; 2Department of Radiology, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yiming Zeng, Department of Pulmonary and Critical Care Medicine, the Second Affiliated Hospital of Fujian Medical University, Center of Respiratory Medicine of Fujian Province, No. 34, Zhongshanbei Road, Licheng District, Quanzhou, People’s Republic of China, Tel +86 13515042402, Fax +86 0595 22770258, Email [email protected]: Surgical bullectomy is the standard treatment of giant emphysematous bulla (GEB). However, bronchoscopic treatment should be considered as an alternative approach for patients who are unfit for surgical treatment. The study aimed to evaluate the clinical efficacy of endobronchial occlusion for the treatment of GEB using silicone plugs.Methods: This retrospective study recruited four patients with GEB who were unsuitable for surgery. Preoperative planning was performed using high-resolution computed tomography and a virtual bronchoscopic navigation system. Customized silicone plugs were then placed in the target airway via bronchoscopy to cause GEB regression and atelectasis.Results: All procedures were completed successfully in four patients. Three months after the procedures, compared with baseline, increases in the mean forced expiratory volume in 1 s (from 1.20 L/s to 1.33 L/s), forced vital capacity (from 2.63 L to 2.90 L), diffusion lung capacity for carbon monoxide (from 29% to 41% of the predicted value) and 6-minute walking test (from 412 m to 474 m) were observed. Additionally, the mean total lung capacity (from 6.80 L to 6.35 L), residual volume (from 3.97 L to 3.52 L), and St. George’s Respiratory Questionnaire scores (from 67 to 45) were all lower than baseline data.Conclusion: Our preliminary results demonstrated that the endobronchial placement of silicone plugs could be a low-cost, safe, and effective choice for the treatment of GEB in surgically unfit patients.Keywords: giant bulla, bronchoscopy, silicone spigot, endobronchial occlusion

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