Endoscopic valve bronchial placement

The aim of study: The objective of the study was to evaluate the effectiveness of endoscopic bronchial valve placement in the treatment of patients with bronchopleural fistulas and prolonged air leaks of various etiologies. Material and methods: endoscopic bronchial valve placement was performed in 229 patients with bronchopleural fistulas or air leaks in the postoperative period (men - 188; women - 47). The patients’ age ranged from 14 to 73 years (mean 50.38±17.00 years). The patients were divided into 6 groups, depending on the nosology: operated on for bullous emphysema of the lungs, with acute purulent diseases of the lungs, including complications of COVID-19, with chronic purulent diseases of the lungs and pleura, with bullous emphysema of the lungs complicated by pneumothorax in whom it was not possible to achieve lung straightening during drainage of the pleural cavity, blocking for palliative purposes and other lung diseases, and in whom prolonged air discharge through the drains was noted after surgery. Results. There were no complications during the procedure. In most patients (180-78.6%), the installation of the valve led to the cessation of air leakage within 2-3 days. In 19 cases (8.29%), an additional blocker was installed or replaced with a larger one. The final blocking efficiency was 86.89% - 199 patients. In 6 patients, with a long-term (more than 4 months) valve placement cicatricial obliteration of the bronchus occurred, which was successfully treated by endoscopic methods. Conclusion. Endoscopic bronchial valve placement is a highly effective minimally invasive method of treating patients with various lung pathologies, which can be widely used in the practice of many thoracic surgery departments. Efficiency and its absence in patients with various diseases require further analysis and development of tactics with possible additional blockade or replacement of the valve with a larger one. Patients with endobronchial valve duration of more than 4 months should be included in the risk group for the development of cicatricial stenosis and obliteration of the bronchus.