Endobronchial tumor debulking with a flexible cryoprobe for immediate treatment of malignant stenosis

被引:106
作者
Schumann, Christian [1 ]
Hetzel, Martin [2 ]
Babiak, Alexander J. [2 ]
Hetzel, Juergen [3 ]
Merk, Tobias [1 ]
Wibmer, Thomas [1 ]
Lepper, Philipp M. [4 ,5 ]
Krueger, Stefan [1 ,6 ]
机构
[1] Univ Ulm, Clin Internal Med 2, Ctr Internal Med, D-89081 Ulm, Germany
[2] Red Cross Hosp, Clin Pneumol & Internal Med, Stuttgart, Germany
[3] Univ Tubingen, Dept Internal Med 2, Tubingen, Germany
[4] Univ Hosp Bern, Inselspital, Dept Pneumol, CH-3010 Bern, Switzerland
[5] Univ Bern, Bern, Switzerland
[6] Univ Clin Aachen, Med Clin 1, Aachen, Germany
关键词
ARGON PLASMA COAGULATION; AIRWAY-OBSTRUCTION; THERAPEUTIC BRONCHOSCOPY; LUNG-CANCER; CRYORECANALIZATION; HEMOPTYSIS;
D O I
10.1016/j.jtcvs.2009.06.023
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: In addition to use of a laser, argon plasma coagulation, electrocautery, or coring with a rigid bronchoscope, tumor debulking with a flexible cryoprobe is used for therapeutic bronchoscopy with an immediate effect for endobronchial pathologies. We performed this analysis to determine the usefulness, efficacy, and safety of the flexible cryorecanalization in a large population under routine conditions. Methods: We identified 225 bronchoscopic interventions that were done as cryorecanalization with a flexible cryoprobe. All patients had symptomatic airway stenosis. We determined the endoscopic success rate and safety (bleeding and perforation) of the procedure. Results: Successful cryorecanalization was achieved in 205 (91.1%) of 225 patients. The flexible cryoprobe was used with all patients, in most patients in combination with flexible bronchoscopy and only in a minority (n = 31, 13.8%) in combination with a rigid bronchoscope. Additional interventional techniques used were endobronchial stents (n = 11, 4.9%) and argon plasma coagulation (n = 37, 16.4%). Mild bleeding (if ice-cold NaCl or epinephrine solution was necessary) occurred in 9 (4.0%) patients, moderate bleeding (if argon plasma coagulation or a bronchus blocker was required) occurred in 18 (8.0%) patients, and severe bleeding (events with hemodynamic instability) never occurred. Conclusions: Cryorecanalization with the flexible cryoprobe for treatment of symptomatic endobronchial tumor stenosis is a safe technique with a high success rate and immediate treatment effect. (J Thorac Cardiovasc Surg 2010; 139: 997-1000)
引用
收藏
页码:997 / 1000
页数:4
相关论文
共 13 条
  • [1] Therapeutic bronchoscopy with immediate effect: laser, electrocautery, argon plasma coagulation and stents
    Bolliger, C. T.
    Sutedja, T. G.
    Strausz, J.
    Freitag, L.
    [J]. EUROPEAN RESPIRATORY JOURNAL, 2006, 27 (06) : 1258 - 1271
  • [2] ERS/ATS statement on interventional pulmonology
    Bolliger, CT
    Mathur, PN
    [J]. EUROPEAN RESPIRATORY JOURNAL, 2002, 19 (02) : 356 - 373
  • [3] Central airway obstruction
    Ernst, A
    Feller-Kopman, D
    Becker, HD
    Mehta, AC
    [J]. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2004, 169 (12) : 1278 - 1297
  • [4] Cryorecanalization: A new approach for the immediate management of acute airway obstruction
    Hetzel, M
    Hetzel, J
    Schumann, C
    Marx, N
    Babiak, A
    [J]. JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2004, 127 (05) : 1427 - 1431
  • [5] Endobronchial argon plasma coagulation for treatment of hemoptysis and neoplastic airway obstruction
    Morice, RC
    Ece, T
    Ece, F
    Keus, L
    [J]. CHEST, 2001, 119 (03) : 781 - 787
  • [6] Reichle G, 2000, Pneumologie, V54, P508, DOI 10.1055/s-2000-8254
  • [7] Salajka F, 1999, SCHWEIZ MED WSCHR, V129, P1487
  • [8] Therapy of exophytic bronchial tumorous stenosis by flexible cryoprobe
    Schumann, C.
    Kropf, C.
    Wibmer, T.
    Merk, T.
    Krueger, S.
    [J]. EUROPEAN RESPIRATORY JOURNAL, 2006, 28 (06) : 1286 - 1287
  • [9] Successful immediate cryorecanalization of a simultaneous high-grade tracheal and bronchial stenosis as rare manifestations of bronchial-associated lymphoid tissue lymphoma
    Schumann, Christian
    Lepper, Philipp M.
    Barth, Thomas F. E.
    Moeller, Peter
    Krueger, Stefan
    [J]. JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2009, 137 (01) : E17 - E19
  • [10] The association between hospitalisation for pneumonia and the diagnosis of lung cancer
    Soyseth, Vidar
    Benth, Jurate Saltyte
    Stavem, Knut
    [J]. LUNG CANCER, 2007, 57 (02) : 152 - 158