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Endobronchial Valve as Treatment of Emphysema Compared with Standard Medical Care: an Evidence-based Case Report

Eric Tenda, Abraham Yakub, Eric Tenda
unpublished
ABSTRAK Tujuan: menilai efektivitas penggunaan endobronchial valve sebagai tatalaksana pasien dengan emfisema dibandingkan dengan tatalaksana medikal. Metode: pencarian kepustakaan mengenai perbandingan pengunaan endobronchial valve dan tatalaksana medikal pada emfisema di PubMed database. Kualitas dari kepustakaan yang didapat dinilai dengan menggunakan daftar tilik dari Center of Evidence-Based Medicine, University of Oxford. Hasil: dua randomized controlled trial (RCT) didapatkan dari
more » ... apatkan dari pencarian kepustakaan. Didapatkan bahwa terapi dengan endobronchial valve meningkatkan kualitas pasien emfisema derajat sedang hingga sangat berat secara bermakna dibandingkan dengan tatalaksana medikal. Akan tetapi, peningkatan bermakna tersebut terjadi pada pasien emfisema dengan heterogenitas tinggi, fissura interlobar lengkap, dan ketiadaan ventilasi kolateral. Kesimpulan: endobronchial valve merupakan terapi yang lebih efektif pada pasien emfisema dengan keheterogenan tinggi, fissura interlobar lengkap, dan ketiadaan ventilasi kolateral. Pemeriksaan dengan High Resolution CT-scan (HRCT) harus dilakukan untuk memutuskan apakah terapi dengan endobronchial valve cocok untuk dilakukan pada seorang pasien dengan emfisema. Kata kunci: endobronchial valve, talalaksana medikal, emfisema. ABSTRACT Aim: to determine the effectiveness of endobronchial valve placement as treatment of emphysema compared to medical care. Methods: literature searching regarding comparison of endobronchial valve and medical care as treatment of emphysema on PubMed database. The quality of the literatures found was appraised by using critical appraisal sheet from Center of Evidence-Based Medicine, University of Oxford. Results: two randomized controlled trials (RCT) were obtained from literature searching. It was revealed that endobronchial valve placement improved quality of patients with moderate to very severe as compared to medical treatment significantly. However, these significant improvements occurred in patients with high heterogeneity emphysema, complete interlobar fissure, and absence of collateral ventilation. Conclusion: endobronchial valve placement was a more effective treatment in patients with high heterogeneity emphysema, complete interlobar fissure, and absence of collateral ventilation. Assessment by using High Resolution CT-scan (HRCT) must be conducted prior to valve placement to determine suitability of this approach in emphysema patients.
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