Late-breaking abstract: Risk of endoscopic lung volume reduction in patients with previous lung surgery including lung volume reduction surgery

Background: there is a lack of data about the safety of endoscopic lung volume reduction (LVR) in patients with previous lung surgery Objectives: the aim of the analysis was to find out whether endoscopic LVR can safely be performed following surgical LVR Methods: data of 12 patients with previous surgical LVR undergoing endoscopic LVR using flexible bronchoscopy under propofol sedation were analyzed. Lung function tests, blood gas analysis, medication requirements, duration of procedure, adverse events were prospectively documented. The site of insertion of valves or coils was based on SPECT findings Results: 16 interventions in 12 patients were performed. Mean age was 65 ± 9 years (42% female, 58% long term oxygen therapy, 8% home ventilation, BMI 23 kg/m2). Mean FEV1 was 25% pred, mean residual volume 185% pred, mean diffusion capacity 33% pred, mean partial pressure of oxygen 64 mmHg. Median interval from lung surgery to endoscopic LVR was 54 months (range 5 - 138). Median hospital stay after the procedure was 1 day (range 1 - 5). 6 interventions were performed for valves (upper lobes in 5, lower lobes in 4 patients, median 6 valves), 10 for coils insertion (upper lobes in 7, lower lobes in 3 interventions, median 9 coils). Propofol requirements were 462 mg (0.206 mg/kg/min). Mean duration of bronchoscopy was 42.1 min. A lowest systolic pressure of <90 mmHg was found in 75% of patients, an oxygen saturation of <90% in 16% of patients. There was no pneumothorax, no ICU transfer. 30 day mortality was 0%. Minor bleeding occured in 44%, COPD exacerbation in 31% Conclusions: endoscopic LVR through flexible bronchoscopy in patients with previous lung surgery is safe