Cryosurgery for Malignant Endobronchial Tumors

Asimakopoulos, George; Beeson, Julia; Evans, Joanna M.; Maiwand, M. Omar

doi:10.1378/chest.127.6.2007

Cited by 81 publications

(67 citation statements)

References 22 publications

(19 reference statements)

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“…Cryotechnology has been used as a therapy for central airway obstruction and hemoptysis (19). The samples from cryotechnology are larger than conventional forceps biopsy and have better diagnostic yield (95% to 100%) (3,20,21) (Figure 1).…”

Section: Tissue Sampling: Forceps Versus Cryotechnologymentioning

confidence: 99%

“…The overall success rate of significant recanalization exceeds 80% in one systematic review (44). In additional to improvement in dyspnea, cough, and hemoptysis, the lung function, performance status are also improved after cryotherapy (19). When combined with systemic chemotherapy and/or radiation, the survival benefit is significant (9,45).…”

Section: Cryotherapymentioning

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: Tissue Sampling: Forceps Versus Cryotechnologymentioning

confidence: 99%

Section: Cryotherapymentioning

confidence: 99%

Central airway tumors: interventional bronchoscopy in diagnosis and management

Lin

Chung

2016

J. Thorac. Dis.

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“…It is a treatment option for patients with an airway obstruction, alternative to laser, diathermia, photodynamic therapy and stent applications [10][11][12][13][14][15][16]. Cryotherapy with minimal complication ratios were reported to be a good tolerated method by Maiwant et al [17][18].…”

Section: Discussionmentioning

confidence: 99%

Acute histopathological effects of cryotherapy on lung tissue

Yoldaş¹,

Çakan²,

Çağırıcı³

et al. 2016

Curr Thorac Surg

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“…It has been proposed that the collagenous architecture of the tracheobronchial tree and hilar vasculatures are relatively resistant to the effects of cryoablation (38). Indeed, an endoluminal approach to the cryoablation of tracheobronchial malignancy has been shown to be safe (38)(39)(40)(41)(42)(43). In a recent study, Zhikai et al (44) described their findings regarding the treatment of unresectable central lung tumors with combined endobronchial and percutaneous cryoablation and airway stenting.…”

Section: Discussionmentioning

confidence: 99%