Inter-lobar Fissure Completion as a Salvage Treatment in Patients With Failed Bronchoscopic Lung Volume Reduction

What this Trial Is About

This research aims to evaluate a new lung surgery technique called lung fissure completion with pleural adhesiolysis for patients with severe emphysema or COPD who have not improved after bronchoscopic lung volume reduction using endobronchial valves (EBVs). The goal is to see if this surgery can improve lung function and symptoms in patients who still have poor breathing and little volume reduction despite previous valve treatment. The study is a pilot clinical trial focused on this specific patient group with failed EBV therapy. Participants will undergo a video-assisted thoracoscopic surgery (VATS) or robotic procedure where the surgeon will complete the lung fissure and remove adhesions near the treated lung lobe. This involves anesthesia, small incisions, use of a surgical stapler to close lung tissue gaps, and managing any air leaks or complications. After surgery, patients will be closely monitored and receive standard postoperative care. Bronchoscopy will also be performed to examine and adjust the valves if needed. During the study, participants will have follow-up visits at 14 days and 3 months after surgery. Researchers will collect data from medical records including lung function tests, walking distance tests, CT scans, and questionnaires measuring quality of life and breathlessness. The main outcomes measured are the success of fissure completion, safety events, lung volume reduction, and improvements in breathing and quality of life. Participants will be observed for up to two years for these outcomes.

Inter-lobar Fissure Completion in Patients With Failed Bronchoscopic Lung Volume Reduction