Mustafa ÇÖRTÜK, Binnaz Zeynep YILDIRIM, Mehmet Akif ÖZGÜL, Efsun Gonca UĞUR CHOUSEIN, Demet TURAN, Elif TANRIVERDİ, Erdoğan ÇETİNKAYA, Deniz DOĞAN, Barış DEMİRKOL, Halit ÇINARKA

Amfizemli hastaların bronkoskopik volüm azaltıcı coil tedavisinin gerçek yaşam sonuçları

Giriş: Akciğer volüm azaltıcı coil tedavisi, şiddetli hiperinflasyonu olan amfizem hastaları için minimal invaziv bir bronkoskopik tedavi seçeneğidir. Yapılan çalışmalarda, seçilmiş olgularda başarılı sonuçlar bildirilmiştir. Amacımız endobronşiyal coil tedavisi uygulanan hastalarda, solunum fonksiyon testleri, dispne algısı ve egzersiz kapasitelerinin 12. ay sonundaki değişikliklerini değerlendirmektir. Materyal ve Metod: Şiddetli amfizemi olan ve 2014-2017 yılları arasında endobronşiyal coil tedavisi uygulanan hastaların verileri retrospektif olarak değerlendirildi. Başlangıç değerleri ve 12 ay sonunda dinamik ve statik akciğer hacmi kapasiteleri, “modified Medical Research Council (mMRC)” skorları ve altı dakikalık yürüme testi (6-MWT) sonuçları kaydedildi. Bulgular: Bronkoskopik akciğer volüm azaltıcı coil tedavisi, 30 (1 kadın, 29 erkek) hastaya uygulandı. Beş hasta bilateral, 25 hasta unilateral tedavi aldı. Bir hasta işlemden yedi gün sonra, dört hasta takip sırasında eksitus oldu. Beş hasta takiplerine gelmedi. Çalışmaya 12. ay verileri bulunan 20 hasta dahil edildi. mMRC sonuçlarında tedavi öncesi ve 12 aylık değerlendirmelerde istatistiksel olarak anlamlı bir fark bulundu. On iki ay sonunda FEV1, TLC ve RV değerlerinde anlamlı fark yoktu. 6-MWT’de başlangıç ile 12 ay arasında 18.9 m (± 83.5 m) artış oldu. Hastaların %45’i yürüme mesafesini, minimal klinik anlamlı sonuç (MCID) olarak bilinen 26 m’nin üzerinde artırdı. Sonuç: Solunum fonksiyon testlerinde ve akciğer hacimlerinde anlamlı bir değişiklik gözlenmemesine rağmen, egzersiz kapasitesindeki artış ve dispne algısındaki azalma endobronşiyal coil tedavisinin etkinliğini göstermektedir.

Real life results of coil treatment for bronchoscopic lung volume reduction in emphysema

Introduction: The lung volume reduction coil treatment is a minimally invasivebronchoscopic treatment option for emphysema patients who suffer from severehyperinflation. Previous studies have reported successful outcomes in selectedcases using coil for bronchoscopic lung volume reduction (BLVR). Our aim is todetermine the changes in respiratory function tests, perception of dyspnea andexercise capacities after 12 months in patients treated with endobronchial coil.Materials and Methods: The data of patients with severe emphysema andtreated with coils between 2014-2017 were evaluated retrospectively.Dynamic and static lung volume capacities at baseline and 12 months, modified Medical Research Council (mMRC) questionnaire and six-minute walktest (6-MWT) results were recorded.Results: BLVR was performed in thirty patients (one female, twenty-ninemales). Five patients were treated bilaterally and twentyfive unilaterally. Onepatient died after 7 days and 4 patients died during follow-up. Five patientswere lost to follow-up. A total of twenty patients with available data wereincluded in the study. A statistically significant difference was found in mMRCresults in pre-treatment and 12-month evaluations. There was no significantdifference in FEV1, TLC and RV values at the end of 12 months. There was anincrease of 18.9 meters (± 83.5 m) between the baseline and 12 months in6-MWT. 45% of the patients improved their walking distance over 26 meterswhich is known as minimal clinically important difference (MCID).Conclusion: Although no significant changes were observed in pulmonaryfunction tests and lung volumes, the increase in exercise capacity and decreased perception of dyspnea indicate the efficacy of endobronchial coil.

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