Comparison of two new techniques for the management of malignant central airway obstruction: argon plasma coagulation with mechanical tumor resection versus cryorecanalization

Kızılgöz, Derya; Aktaş, Zafer; Yılmaz, Aydın; Öztürk, Ayperi; Seğmen, Fatih

doi:10.1007/s00464-017-5877-2

Cited by 12 publications

(8 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, patients with airway patency provided by interventional bronchoscopic techniques have the same survival with patients without CAO [19].This evidence suggests that interventional bronchoscopy should be part of conventional therapies in this group of patients. There are many useful studies on rapidly debulking of endobronchial exophytic part of tumor in malignant [8][9][10][11][12][13][14][15][16][17][18][19][20][21]. The success rates of patency of the techniques (used in our study) in the literature are APC+MD 67-96%, CR 73-91%, EC+MD 88-89%, MD 76-90% [8][9][10][11][12][13][14][15][16][17].…”

Section: Discussionmentioning

confidence: 90%

“…Many useful interventional bronchoscopic techniques have been developed to rapidly treat the endoluminal exophytic part of a malignant tumor that causes CAO such as mechanical debridement (MD), laser (L), electrocautery (EC), argon plasma coagulation (APC), cryorecanalization (CR) [8][9][10][11][12][13][14][15][16][17]. Combined methods are currently preferred in combination with each other (eg, APC+MD) and in combination with stents [8,12,18]. In our study, we aimed to determine the efficacy and safety of our methods in the malignant CAO caused by endobronchial exophytic tumors.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Endobronchial management of malignant central airway obstruction: the first 6-year single center experience

Aktaş¹,

Yılmaz²,

Öztürk³

et al. 2019

The European Research Journal

Self Cite

View full text Add to dashboard Cite

Objectives: Central airway obstruction (CAO) develops in 20-30% of lung malignancies during the disease. The symptoms related to obstruction often result in poor quality of life and poor prognosis. Interventional bronchoscopic treatments are now recommended in guidelines to improve quality of life and symptom palliation in this patient group. In our study, we aimed to determine the efficacy and safety of our methods in the malignant CAO caused by endobronchial exophytic tumors. Methods: Between May 2012 and August 2018, 432 endobronchial debulking procedures were performed in 388 patients with symptomatic malignant CAO due to endobronchial exophytic or mixed lesions. Results: Primary lung tumors were the most common cause of airway stenosis (84.0%). The most common debulking technique was argon plasma coagulation assisted mechanical debridement (APC+MD) (79.9%). Airway patency was achieved with additional stents (10.2%) in the operations. The success rate of airway patency was 85.5% in APC+MD method, 75.6% in cryorecanalisation method, 91.7% in electrocautery assisted MD method, 100% in MD method and overall success rate was 85.4%. Stent use rate was significantly higher in the stenosis around main carina (42.9%) than in other localizations (p < 0.001). The overall serious complication rate was 2.1%. Procedure-related dead rate was 0.2%. Conclusions: Endobronchial treatment of malignant CAO with interventional bronchoscopic procedures is effective and safe. The first 6 years of experience in our interventional pulmonary clinic show that it has similar characteristics with the world experience in the endobronchial treatment of malignant CAO.

show abstract

Section: Discussionmentioning

confidence: 90%

mentioning

confidence: 99%

Endobronchial management of malignant central airway obstruction: the first 6-year single center experience

Aktaş¹,

Yılmaz²,

Öztürk³

et al. 2019

The European Research Journal

Self Cite

View full text Add to dashboard Cite

show abstract

“…Most patients with lung cancer are diagnosed at the advanced stage with poor health condition, which is a bad timing for surgery [10]. Due to the particularity of lung cancer lesions, excessive growth of tumor tissues can induce airway stenosis and obstruction in patients, leading to dyspnea or shock [11]. Chemoradiotherapy can inhibit the growth of tumor tissues, but cannot timely relieve the dyspnea caused by central airway obstruction, so it is not suitable for critical patients [12, 13].…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy of argon plasma coagulation combined with cryotherapy for central airway stenosis caused by lung cancer

Wang

2019

J Cardiothorac Surg

View full text Add to dashboard Cite

Background: This study aimed to study the clinical efficacy of argon plasma coagulation plus cryotherapy for central airway stenosis caused by lung cancer. Methods: The clinical data of 177 patients with central airway stenosis caused by lung cancer received surgery from June, 2017 to July 2018 were retrospectively analyzed. According to different treatments, 43 patients received cryotherapy were included in the control group, while 134 patients received argon plasma coagulation plus cryotherapy were in the observation group. After propensity score matching, patients in the two groups were in a 1:1 ratio. The Karnofsky score, partial pressure of oxygen (PaO 2), arterial oxygen saturation (SaO 2), partial pressure of arterial carbon dioxide (PaCO 2) and adverse reactions in patients were analyzed one week before and after treatment. Besides, the survival rates of the two groups were compared. Results: After propensity score matching, the baseline data were not significantly different between the two groups. The post-treatment Karnofsky scores in the two groups were significantly higher than those of before treatment, and the post-treatment score of the observation group was higher than that of the control group (all P < 0.05). The posttreatment PaO 2 and SaO 2 in the observation group were both higher than those of the control group; while the PaCO 2 in the observation group was significantly lower than that of the control group (all P < 0.05). In the observation group, the levels of PaO 2 and SaO 2 were significantly higher, and the level of PaCO 2 was significantly lower after treatment than those of before treatment (all P < 0.05). The rates of completely effective and mild effective in the observation group were significantly higher than those in the control group (both P < 0.05). The incidences of bleeding, arrhythmia and fever in the observation group were significantly lower than those in the control group (all P < 0.05). The survival rate was significantly higher in the observation group (72.09%) than in the control group (51.16%). Conclusions: Argon plasma coagulation combined with cryotherapy can significantly alleviate the central airway stenosis caused by lung cancer, reduce the incidence of adverse reactions, and improve prognosis in patients.

show abstract

“…Tissue desiccation is also homogeneous in contrast to lasers. APC has been proven to [32][33][34] It is commonly used in a malignant endobronchial lesion with hemoptysis but has also been found useful in treating rare endobronchial lesions such as hemangiomas, Dieulafoy's lesion, and endobronchial endometriosis. 35,36 Similar to laser photocoagulation, the fraction of inspired oxygen (FiO 2 ) must be maintained below 40% to prevent endobronchial ignition.…”

Section: Argon Plasma Photocoagulationmentioning

confidence: 99%

Life-Threatening Hemoptysis

Deshwal

Sinha

Mehta

2020

Semin Respir Crit Care Med

View full text Add to dashboard Cite

Life-threatening hemoptysis (LTH) is any amount of hemoptysis that causes significant hemodynamic decompensation or respiratory distress which may lead to death if left untreated. While the amount of hemoptysis that qualifies as massive hemoptysis has continued to be debated, any amount between 100 to 1,000 mL/day is considered significant. Up to 15% cases of hemoptysis are LTH and need urgent life-saving intervention. Understanding of pulmonary vascular anatomy is of paramount importance to manage LTH. The goal of treatment lies in airway protection, appropriate oxygenation, and prevention of exsanguination. Once the airway is stabilized, a quick diagnosis and control of bleeding site is targeted. This chapter highlights current practices and approach to LTH including medical management, bronchoscopic approach, and advanced therapies such as bronchial artery embolization and surgical resection. We review situations, such as bronchiectasis, vascular malformation, diffuse alveolar hemorrhage, and tracheostomy bleed and specific approach to management of these conditions in a systematic and evidence-based manner.

show abstract

Comparison of two new techniques for the management of malignant central airway obstruction: argon plasma coagulation with mechanical tumor resection versus cryorecanalization

Abstract: The APC + MTR procedure is preferred over CR to introduce and maintain airway patency in patients with malignancy-related endobronchial exophytic airway obstruction.

Cited by 12 publications

References 15 publications

Endobronchial management of malignant central airway obstruction: the first 6-year single center experience

Endobronchial management of malignant central airway obstruction: the first 6-year single center experience

Clinical efficacy of argon plasma coagulation combined with cryotherapy for central airway stenosis caused by lung cancer

Life-Threatening Hemoptysis

Contact Info

Product

Resources

About