Evidence map›Paper›PMID 38741941›Full record

ArticleInternational journal of chronic obstructive pulmonary disease2024

Bronchoscopic Lung Volume Reduction as the Treatment of Choice versus Robotic-Assisted Lung Volume Reduction Surgery in Similar Patients with Emphysema - An Initial Experience of the Benefits and Complications.

Michelle Lee, Al-Rehan Dhanji, Periklis Perikleous, Ralitsa Baranowski, Kelvin Kar Wing Lau, David Waller

Abstract readComparative Study
In one paragraph

Article in International journal of chronic obstructive pulmonary disease, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Lung volume reduction: surgeryBreathe (Sheffield, England) · 2024
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Michelle LeeDepartment of Thoracic Surgery, Barts Thorax Centre, St Bartholomew's Hospital, London, UK.
Al-Rehan DhanjiDepartment of Thoracic Surgery, Barts Thorax Centre, St Bartholomew's Hospital, London, UK.
Periklis PerikleousDepartment of Thoracic Surgery, Barts Thorax Centre, St Bartholomew's Hospital, London, UK.
Ralitsa BaranowskiDepartment of Thoracic Surgery, Barts Thorax Centre, St Bartholomew's Hospital, London, UK.
Kelvin Kar Wing LauDepartment of Thoracic Surgery, Barts Thorax Centre, St Bartholomew's Hospital, London, UK.
David WallerDepartment of Thoracic Surgery, Barts Thorax Centre, St Bartholomew's Hospital, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: There is an assumption that because EBLVR requires less use of hospital resources, offsetting the higher cost of endobronchial valves, it should therefore be the treatment of choice wherever possible. We have tested this hypothesis in a retrospective analysis of the two in similar groups of patients. Methods: In a 4-year experience, we performed 177 consecutive LVR procedures: 83 patients underwent Robot Assisted Thoracoscopic (RATS) LVRS and 94 EBLVR. EBLVR was intentionally precluded by evidence of incomplete fissure integrity or intra-operative assessment of collateral ventilation. Unilateral RATS LVRS was performed in these cases together with those with unsuitable targets for EBLVR. Results: EBLVR was uncomplicated in 37 (39%) cases; complicated by post-procedure spontaneous pneumothorax (SP) in 28(30%) and required revision in 29 (31%). In the LVRS group, 7 (8%) patients were readmitted with treatment-related complications, but no revisional procedure was needed. When compared with uncomplicated EBLVR, LVRS had a significantly longer operating time: 85 (14-82) vs 40 (15-151) minutes (p<0.001) and hospital stay: 7.5 (2-80) vs 2 (1-14) days (p<0.01). However, LVRS had a similar total operating time to both EBLVR requiring revision: 78 (38-292) minutes and hospital stay to EBLVR complicated by pneumothorax of 11.5 (6.5-24.25) days. Use of critical care was significantly longer in RATS group, and it was also significantly longer in EBV with SP group than in uncomplicated EBV group. Conclusion: Endobronchial LVR does use less hospital resources than RATS LVRS in comparable groups if the recovery is uncomplicated. However, this advantage is lost if one includes the resources needed for the treatment of complications and revisional procedures. Any decision to favour EBLVR over LVRS should not be based on the assumption of a smoother, faster perioperative course.

Indexed as

BronchoscopyLungPneumonectomyPulmonary EmphysemaRobotic Surgical ProceduresAgedClinical Decision-MakingFemaleHumansLength of StayMaleMiddle AgedOperative TimePatient ReadmissionPneumothoraxPostoperative Complicationsbronchoscopic lung volume reductionemphysemaendobronchial valvelung volume reductionlung volume reduction surgery

Identifiers

PMID38741941
PMCPMC11090187

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.