Cryosurgery for the treatment of benign tracheo-bronchial lesions*1

Abstract

Although cryosurgery has been shown to be effective in managing advanced malignant bronchial tumours, there is very little in the literature describing its use with benign lesions. In this study, we retrospectively assessed the effectiveness of cryosurgery in the management of non-malignant endobronchial lesions. Between 1995 and 1999, 20 patients with benign tumours and non-neoplastic lesions of the tracheo-bronchial tree were treated with endobronchial cryosurgery. The procedures were performed under general anaesthesia, using specifically designed cryoprobes. The patients were assessed clinically, radiologically and by respiratory function tests before and after each cryotreatment. Over the 5-year period, each patient received a mean 2.6 (range 1-9) cryo-applications, with no peri-operative deaths. All patients described a subjective improvement in at least one of their symptoms (cough, haemoptysis, stridor, chest pain or dyspnoea) following cryosurgery and 75% of patients improved in all symptoms. Following surgery, both forced expiratory volume in 1 s (2.23+/-0.27 vs. 1.98+/-0.25 l, P<0.05) and forced vital capacity (2.86+/-0.33 vs. 2.62+/-0.30 l, P<0.01) improved significantly. In conclusion, cryosurgery can provide effective symptomatic control in patients with non-malignant endobronchial lesions, the majority of whom are discharged on the day of surgery. It affords an easy to perform, safe procedure, which should be considered for patients with benign endobronchial lesions.

Acute histopathological effects of cryotherapy on lung tissue

“…Cryotherapy with minimal complication ratios were reported to be a good tolerated method by Maiwant et al [17][18]. Moorjani et al indicated that in none of the cases, bronchial perforation or mortality was seen and highlighted the priority of the method [19].…”

CT-guided percutaneous cryoablation of central lung tumors

“…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.…”

Interventional Bronchoscopy for the Treatment of Malignant Central Airway Stenosis: An Expert Recommendation for China

“…By heat or cold ablation technology, the tumor tissues can be necrosed, carbonized, and even vaporized to achieve the purpose of eliminating the lesion. It mainly includes thermal ablation and cold ablation [21]. Thermal ablation refers to the use of microwave, laser, high-frequency electrotome and argon plasma coagulation to heat tissue, or induce necrosis and vaporization of tissue, thereby reducing the volume of tumor tissue [22-24].…”