Argon Plasma Coagulation and Electrosurgery for Benign Endobronchial Tumors

Miller, Stacey M.; Bellinger, Christina; Chatterjee, Arjun B.

doi:10.1097/lbr.0b013e318282d3ca

Cited by 27 publications

(24 citation statements)

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“…Not only significant endobronchial tumor reduction, clinical dyspnea score and forced expiratory volume in one second (FEV1) are also improved after procedure (37). Because of the superficial effect and superiority in hemostasis, APC is usually used as a part of multi-modality approach for tumor debulking (33).…”

Section: Argon Plasma Coagulation (Apc)mentioning

confidence: 99%

“…APC is a non-contact method of electrocautery and can be introduced via both rigid and flexible bronchoscopy (33). The noncontact feature of APC allows extent and rapid coagulation, but the depth of penetration is more superficial (2-3 mm) and limited by increased tissue resistance after coagulation and desiccation (33,34).…”

Section: Argon Plasma Coagulation (Apc)mentioning

confidence: 99%

“…The noncontact feature of APC allows extent and rapid coagulation, but the depth of penetration is more superficial (2-3 mm) and limited by increased tissue resistance after coagulation and desiccation (33,34). The major applications of APC are hemostasis and tissue destruction and particular effective in vascular lesion (35).…”

Section: Argon Plasma Coagulation (Apc)mentioning

confidence: 99%

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Central airway tumors: interventional bronchoscopy in diagnosis and management

Lin

Chung

2016

J. Thorac. Dis.

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The diagnosis of central airway tumors is usually challenging because of the vague presentations.Advances in visualization technology in bronchoscopy aid early detection of bronchial lesion. Cryotechnology has great impact on endobronchial lesion sampling and provides better diagnostic yield. Airway tumor involvements result in significant alteration in life quality and lead to poor life expectancy. Timely and efficiently use ablation techniques by heat or cold energy provide symptoms relief for central airway obstruction. Prostheses implantation is effective in maintaining airway patency after ablative procedure or external compression. Combined interventional bronchoscopy modalities and other adjunctive therapies have improvement in quality of life and further benefit in survival. This review aims to provide a diagnostic approach to central airway tumors and an overview of currently available techniques of interventional bronchoscopy in managing symptomatic central airway obstruction. Here, we provide a clinical review of interventional bronchoscopy in diagnoses and management of central airway tumors. Keywords Diagnostic modalities Computed tomographyOnly less than 30% patients with tracheal tumors have been diagnosed via chest radiography (14). Traditional CT scan is more sensitive and can provide information on the extent of airway lesions. Newly developed multidetector CT (MDCT) can accurately detect airway tumor locations, natures, quantities (1). The extra luminal anatomy is also clearly depicted. Thus, MDCT is a rapid and non-invasive method to provide comprehensive information about the extent of disease process before surgery or interventional bronchoscopy (1). Visualization of bronchoscopyBronchoscopy is the mainstay to approaching endobronchial lesion under direct vision. In addition to conventionally white light bronchoscopy, autofluorescence (AFB) and narrow band imaging (NBI) are new visualization techniques of bronchoscopy which can aid detection of bronchial mucosa lesions (15). Although the specificity of AFB is low and similar to white light bronchoscopy, there is no doubt in usefulness of detecting early bronchial mucosal lesion and evaluate the margin of mucosal involvement (16,17). NBI is designed to detect angiogenesis and neovascular lesion. The diagnostic accuracy is increased under NBI bronchoscopy (15). Both of them have superior sensitivity comparing with white light bronchoscopy [3][4][5]. Endobronchial ultrasonography (EBUS) is also helpful in evaluating the extent of airway lesion involvement (14,18). Tissue sampling: forceps versus cryotechnologyForceps biopsy under direct bronchoscopic vision is the most common method to obtain tissue sample from endobronchial lesion. However, the size of tissue sample is limited by the forceps size. Small samples with crush artifacts are probably insufficient for accurate diagnosis. The diagnostic yield is only 85% of conventional forceps biopsy and patients usually have to repeat bronchoscopy (2,3).Cryotechnology has been used as a t...

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Section: Argon Plasma Coagulation (Apc)mentioning

confidence: 99%

Section: Argon Plasma Coagulation (Apc)mentioning

confidence: 99%

Section: Argon Plasma Coagulation (Apc)mentioning

confidence: 99%

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Central airway tumors: interventional bronchoscopy in diagnosis and management

Lin

Chung

2016

J. Thorac. Dis.

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“…5,[6][7][8][9][10][11][12][13][14][15][16][17]22,[25][26][27][28][29] In the present study, the effectiveness and safety of APC and EC for treating endoluminal and mixed central airway lesions of benign and malignant causes were presented.…”

Section: Discussionmentioning

confidence: 99%

“…Effective treatment were reported in papillomatosis, hamartoma, pleomorphic adenoma, endobronchial metastases. [6][7][8][9][10][11][12][13][14][15][16]25,26,28,29 Masanori et al reported successful treatment outcomes with APC in 2 cases with post-intubation stenosis in 2006. 16 In 2012, Faguang et al also reported successful results with APC in 41 patients having endobronchial tuberculosis.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic Bronchoscopy In Patients with Symptomatic Airway Lesions Argon Plasma Coagulation / Electrocautery

Mertoğlu¹

2015

UHOD

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Endobronchial treatments are widely used for treating airway obstruction with the goal of relieving large airway obstructions caused by malignant or benign lesions. However, they may be curative in patients with benign conditions. We aimed to evaluate the usefulness of endobronchial argon plasma coagulation (APC) and electrocautery (EC) for treating patients with airway obstruction. Methods: We conducted a retrospective study in the bronchoscopy unit of a training and research hospital. Endobronchial treatment was carried out in 56 evaluable patients between 2007 and 2012. We used a rigid bronchoscope in 18 patients and flexible bronchoscope in 38 patients. General anaesthesia was administered to 32% (18 patients) patients. Bronchogenic carcinoma was seen in 43 patients, metastatic bronchial tumours in 1, and benign airway disease in 12. Obstruction sites were the trachea in 15 patients, main stem bronchi in 28 and lobar bronchi in 5. Eight patients had obstruction at multiple sites. Mean degree of obstruction was 84%. Immediately after the treatment, the mean degree of obstruction was 44%. Mean overall decrease in degree of obstruction was 39%. Post-tretament improvement of dyspnoea was excellent in 31 cases (55%) and moderate in 23 cases (41%); dyspnoea improvement was absent in 2 cases. Three complications (2 cases of respiratory insufficiency, 1 of mediastinal emphysema) were directly related to the endobronchial treatment. Conclusion: APC and EC are effective, rapid and repeatable techniques for treating endoluminal airway lesions and can effectively decrease dyspnoea.Keywords: Airway obstruction, Argon plasma coagulation, Electrocoagulation, Bronchoscopy ÖZET Semptomatik Hava Yolu Lezyonu Olan Hastalarda Bronkoskopik Tedavi Argon Plazma Koagülasyonu /ElektrokoterEndobronşiyal tedaviler, malign ya da benign lezyonların neden olduğu büyük hava yolu obstrüksiyonlarında palyatif amaçla yaygın olarak kullanılmaktadır. Bu tedaviler benign durumlarda küratif olabilmektedir. Bu çalışmada hava yolu obstrüksiyonlarının tedavisinde endobronşiyal argon plazma koagülasyonu (APC) ve elektrokoterin (EC) yararlılığını değerlendirmeyi amaçladık. Çalışma retrospektif olarak bir eğitim araştırma hastanesi bronkoskopi ünitesinde yürütüldü. 2007-2012 yılları arasında 56 hastaya endobronşiyal tedavi uygulandı. On sekiz hastada rijid, 38 hastada fiberoptik bronkoskop ile işlem yapıldı. Hastaların %32 sinde (18 hastada ) genel anestezi uygulandı . Kırküç olguda bronş karsinomu, 1 olguda metastatik tümor, 12 hastada benign hava yolu darlığı mevcuttu. Onbeş hastada trakeada, 28 hastada ana bronşta, 5 hastada lober bronş düzeyinde, 8 hastada birden fazla yerde obstrüksiyon mevcuttu. Obstrük-siyon derecesi ortalaması %84 idi. Tedaviden hemen sonra saptanan obstrüksiyon derecesi ortalaması %44 idi. Obstrüksiyon derecesindeki azalmanın ortalaması %39 olarak bulundu. Tedavi sonrası dispnede düzelme 31 olguda(%55) "mükemmel", 23 olguda(41) "orta düzeyde" saptandı, 2 olguda dispnede düzelme görülmedi. Endobronşiyal tedavi ile iliş...

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Interventional Pulmonology

Perin¹,

Zarić²

2022

Medical Radiology

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Argon Plasma Coagulation and Electrosurgery for Benign Endobronchial Tumors

Abstract: APC is an effective method for tumor devitalization and reduction in tumor size, making it a viable and less costly therapeutic option for the treatment of benign endobronchial tumors.

Cited by 27 publications

References 5 publications

Central airway tumors: interventional bronchoscopy in diagnosis and management

Central airway tumors: interventional bronchoscopy in diagnosis and management

Therapeutic Bronchoscopy In Patients with Symptomatic Airway Lesions Argon Plasma Coagulation / Electrocautery

Interventional Pulmonology

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Argon Plasma Coagulation and Electrosurgery for Benign Endobronchial Tumors

Abstract: APC is an effective method for tumor devitalization and reduction in tumor size, making it a viable and less costly therapeutic option for the treatment of benign endobronchial tumors.

Cited by 27 publications

References 5 publications

Central airway tumors: interventional bronchoscopy in diagnosis and management

Central airway tumors: interventional bronchoscopy in diagnosis and management

Therapeutic Bronchoscopy In Patients with Symptomatic Airway Lesions Argon Plasma Coagulation / Electrocautery

Interventional Pulmonology

Contact Info

Product

Resources

About

Therapeutic Bronchoscopy In Patients with Symptomatic Airway Lesions Argon Plasma Coagulation / Electrocautery