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Life
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Interventional Pulmonology – Review and Updates
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Interventional Pulmonology – Review and Updates

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (28 April 2023) | Viewed by 18856

Special Issue Editors

Dr. George Z. Cheng

E-Mail Website
Guest Editor
Division of Pulmonary, Critical Care and Sleep Medicine, UC San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
Interests: research updates in pleural effusions
Special Issues, Collections and Topics in MDPI journals
Dr. Jason Akulian

E-Mail Website
Guest Editor
Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, Durham, NC 27599, USA
Interests: interventional pulmonology; bronchoscopy; pleural disease
Dr. Russell Miller

E-Mail Website
Guest Editor
Department of Pulmonary, Critical Care, and Sleep Medicine, Naval Medical Center San Diego, San Diego, CA 92134, USA
Interests: interventional pulmonology; bronchoscopy; pleural disease

Special Issue Information

Dear Colleagues,

Interventional pulmonology field had undergone an extraordinary growth in the past three decades. Advances in clinical innovations, research, and education has pushed interventional pulmonology to the forefront. In this issue, we aim to provide a summary of what has been accomplished in the past three decades and visit active areas of research.

Dr. George Z. Cheng
Dr. Jason Akulian
Dr. Russell Miller
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (6 papers)

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Research

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12 pages, 1863 KiB  
Article
Pleural Fluid Resolution Is Associated with Improved Survival in Patients with Malignant Pleural Effusion
by Christina R. MacRosty, Amber Wright, Agathe Ceppe, Sohini Ghosh, A. Cole Burks and Jason A. Akulian
Life 2023, 13(5), 1163; https://doi.org/10.3390/life13051163 - 11 May 2023
Viewed by 1723
Abstract
Malignant pleural effusion is associated with a poor prognosis and, while risk stratification models exist, prior studies have not evaluated pleural fluid resolution and its association with survival. We performed a retrospective review of patients diagnosed with malignant pleural effusion between 2013 and [...] Read more.
Malignant pleural effusion is associated with a poor prognosis and, while risk stratification models exist, prior studies have not evaluated pleural fluid resolution and its association with survival. We performed a retrospective review of patients diagnosed with malignant pleural effusion between 2013 and 2017, evaluating patient demographics, pleural fluid and serum composition, and procedural and treatment data using Cox regression analysis to evaluate associations with survival. In total, 123 patients were included in the study, with median survival from diagnosis being 4.8 months. Resolution of malignant pleural fluid was associated with a significant survival benefit, even when accounting for factors such as placement of an indwelling pleural catheter, anti-cancer therapy, pleural fluid cytology, cancer pheno/genotypes, and pleural fluid characteristics. Elevated fluid protein, placement of an indwelling pleural catheter, and treatment with targeted or hormone therapies were associated with pleural fluid resolution. We conclude that the resolution of pleural fluid accumulation in patients with malignant pleural effusion is associated with a survival benefit possibility representing a surrogate marker for treatment of the underlying metastatic cancer. These findings support the need to better understand the mechanism of fluid resolution in patients with malignant pleural effusion as well as the tumor–immune interplay occurring with the malignant pleural space. Full article
(This article belongs to the Special Issue Interventional Pulmonology – Review and Updates)
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13 pages, 2444 KiB  
Article
Learning Curve of Real-Time Imaging with C-Arm Based Tomography for Peripheral Lung Nodule Biopsy
by Grant Senyei, Matthew Nobari, Russell Miller, Brody Harrell and George Z. Cheng
Life 2023, 13(4), 936; https://doi.org/10.3390/life13040936 - 03 Apr 2023
Viewed by 1350
Abstract
The number of procedures required to attain proficiency with new bronchoscopic biopsy technologies for peripheral pulmonary lesions (PPLs) is uncertain. A prospective, single-center study evaluated learning curves of two operators performing PPL biopsies using a novel, real-time, intraoperative tomographic imaging system in consecutive [...] Read more.
The number of procedures required to attain proficiency with new bronchoscopic biopsy technologies for peripheral pulmonary lesions (PPLs) is uncertain. A prospective, single-center study evaluated learning curves of two operators performing PPL biopsies using a novel, real-time, intraoperative tomographic imaging system in consecutive procedures in adults with CT-detected PPLs. Operators were considered “proficient” when they asked three or fewer questions of the manufacturer’s clinical representative with no subsequent navigations in which they asked more than three questions. A total of 31 procedures were performed on 31 patients (Operator 1: 18, Operator 2: 13). Proficiency was achieved after an average of 10 procedures (Operator 1: 12, Operator 2: 8). From the learning curve to the post-learning curve period, the number of questions (median [IQR]: 23 [9.5–41.5] versus 0 [0–1], p < 0.001) and radiation dose (median [IQR]: 19.5 mGy/m2 [1.9–43.5] versus 1.5 mGy/m2 [0.7–3.3], p = 0.05) decreased significantly; procedure time decreased (median [IQR]: 12 min [7–20] versus 8 min [3–15], p = 0.29); and diagnostic yield increased significantly (13/20 cases [65%] to 11/11 cases [100%]), (p = 0.03). Based on this unique, clinically relevant method of assessing learning curve, proficiency with the Body Vision system was achieved at approximately the tenth procedure. These findings require validation in larger, diverse populations. Full article
(This article belongs to the Special Issue Interventional Pulmonology – Review and Updates)
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Review

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15 pages, 3969 KiB  
Review
Bronchoscopic Management of COPD and Advances in Therapy
by Benjamin DeMarco and Christina R. MacRosty
Life 2023, 13(4), 1036; https://doi.org/10.3390/life13041036 - 18 Apr 2023
Viewed by 2764
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a highly prevalent and morbid disease marked by irreversible structural changes in the lungs. Bronchoscopic therapies have significantly expanded the treatment armamentarium for patients with persistent symptoms by reducing the physiologic detriments of hyperinflation in a less [...] Read more.
Chronic Obstructive Pulmonary Disease (COPD) is a highly prevalent and morbid disease marked by irreversible structural changes in the lungs. Bronchoscopic therapies have significantly expanded the treatment armamentarium for patients with persistent symptoms by reducing the physiologic detriments of hyperinflation in a less invasive fashion than surgical lung volume reduction. The spectrum of bronchoscopic techniques to reduce hyperinflation includes endobronchial valves, coils, thermal ablation, and biologic sealants. Other therapies focus on reducing parasympathetic tone and mucus hypersecretion and include targeted lung denervation, bronchial rheoplasty, and cryospray techniques. In this article, we will review the variety of techniques for bronchoscopic lung volume reduction, both established and investigational, along with their respective benefits and complications and will briefly review other investigational therapies for COPD. Full article
(This article belongs to the Special Issue Interventional Pulmonology – Review and Updates)
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18 pages, 1129 KiB  
Review
Pleural Space Infections
by Sean P. F. Foley and John Scott Parrish
Life 2023, 13(2), 376; https://doi.org/10.3390/life13020376 - 29 Jan 2023
Cited by 4 | Viewed by 3951
Abstract
Pleural space infections have been a well-recognized clinical syndrome for over 4000 years and continue to cause significant morbidity and mortality worldwide. However, our collective understanding of the causative pathophysiology has greatly expanded over the last few decades, as have our treatment options. [...] Read more.
Pleural space infections have been a well-recognized clinical syndrome for over 4000 years and continue to cause significant morbidity and mortality worldwide. However, our collective understanding of the causative pathophysiology has greatly expanded over the last few decades, as have our treatment options. The aim of this paper is to review recent updates in our understanding of this troublesome disease and to provide updates on established and emerging treatment modalities for patients suffering from pleural space infections. With that, we present a review and discussion synthesizing the recent pertinent literature surrounding the history, epidemiology, pathophysiology, diagnosis, and management of these challenging infections. Full article
(This article belongs to the Special Issue Interventional Pulmonology – Review and Updates)
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14 pages, 1182 KiB  
Review
Robotic Bronchoscopy: Review of Three Systems
by Maxwell J. Diddams and Hans J. Lee
Life 2023, 13(2), 354; https://doi.org/10.3390/life13020354 - 28 Jan 2023
Cited by 7 | Viewed by 5759
Abstract
Robotic bronchoscopy (RB) has been shown to improve access to smaller and more peripheral lung lesions, while simultaneously staging the mediastinum. Pre-clinical studies demonstrated extremely high diagnostic yields, but real-world RB yields have yet to fully matched up in prospective studies. Despite this, [...] Read more.
Robotic bronchoscopy (RB) has been shown to improve access to smaller and more peripheral lung lesions, while simultaneously staging the mediastinum. Pre-clinical studies demonstrated extremely high diagnostic yields, but real-world RB yields have yet to fully matched up in prospective studies. Despite this, RB technology has rapidly evolved and has great potential for lung-cancer diagnosis and even treatment. In this article, we review the historical and present challenges with RB in order to compare three RB systems. Full article
(This article belongs to the Special Issue Interventional Pulmonology – Review and Updates)
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12 pages, 275 KiB  
Review
Malignant Pleural Effusions: Updates in Diagnosis and Management
by Stephen M. Hughes and Jacob Jonas Carmichael
Life 2023, 13(1), 115; https://doi.org/10.3390/life13010115 - 31 Dec 2022
Cited by 2 | Viewed by 2405
Abstract
Malignant pleural effusions remain a significant clinical problem resulting in greater than 125,000 hospitalizations per year and leading to over 5 billion dollars in healthcare utilization costs. Not only are health care expenditures related to malignant pleural effusion significant, but malignant pleural effusions [...] Read more.
Malignant pleural effusions remain a significant clinical problem resulting in greater than 125,000 hospitalizations per year and leading to over 5 billion dollars in healthcare utilization costs. Not only are health care expenditures related to malignant pleural effusion significant, but malignant pleural effusions also often result in significant patient discomfort and distress, largely at the end of life. Advances in management over the past several years have provided patients with greater autonomy as they are able to provide self-aid at home either alone or with family assistance. Additionally, practice changes have allowed for fewer interventions allowing patients to spend more time out of the clinic or inpatient wards. Full article
(This article belongs to the Special Issue Interventional Pulmonology – Review and Updates)
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