Endobronchial Ultrasound for Benign Tracheal Stenosis

Fiorelli, Alfonso; Messina, Gaetana; Santoriello, Carlo; Santini, Mario

doi:10.1055/s-0038-1668597

Cited by 6 publications

(6 citation statements)

References 5 publications

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“…However, there was no statistical difference in postoperative pharyngeal complications between the 2 groups in the present study, which may be related to the small sample size included in this study; thus, further comparative studies are needed. [19–23]…”

Section: Discussionmentioning

confidence: 99%

Comparison of two different flexible laryngeal airway masks in pediatric ophthalmic surgeries: A retrospective study

Wang

2023

Medicine

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This study aimed to compare the clinical effects of the Medis flexible laryngeal mask airway (FLMA) with those of the Ambu AuraFlex FLMA in pediatric ophthalmic surgery. A total of 80 patients, aged 1 to 5 years, in American Society of Anesthesiologists I–II, weighing ≥10 kg, and without any existing airway difficulties, were enrolled in this study. The patients were randomly divided into Group M (Medis FLMA) and Group A (Ambu AuraFlex FLMA). The time of insertion, number of attempts, finger assistance required, manipulation, oropharyngeal leak pressure (OLP), fiberoptic grade of view, and complications such as bloodstaining, hoarseness, and sore throat were recorded. Group M showed a significantly higher OLP than did Group A ( P = .002); however, Group M required more finger assistance than did Group A ( P = .009). There were no statistically significant differences between the 2 groups in terms of insertion time, number of attempts, manipulation, fiberoptic view grade, or complications. Both the Medis and Ambu AuraFlex FLMA can provide smooth ventilation during pediatric ophthalmic surgeries. The Medis FLMA showed a higher OLP than did the Ambu AuraFlex FLMA but required more finger assistance during insertion.

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Section: Discussionmentioning

confidence: 99%

Comparison of two different flexible laryngeal airway masks in pediatric ophthalmic surgeries: A retrospective study

Wang

2023

Medicine

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“…After intubation, the removal of the mucoid impaction showed an endobronchial tumor originating from the airway wall of the right or left main bronchus, the rigid bronchoscope can be placed in the obstructed main bronchus, ensuring good ventilation management and avoiding blood accumulation in the contralateral bronchus. The lesions were polypoid in appearance, rounded, pinkish in color, and well vascularized, with a hard-elastic consistency [ 10 ].…”

Section: Methodsmentioning

confidence: 99%

Advances in Endoscopic Management of Endobronchial Carcinoid

Messina,

Pica,

Vicario

et al. 2023

JCM

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Introduction: Bronchial carcinoid (BC) tumors represent between 1% and 5% of all lung cancers and about 20–30% of carcinoid tumors; they are classified into two groups: typical and atypical bronchial carcinoids. The aim of the present study was to review the results of endoscopic treatments as an alternative to surgical treatment in selected patients. Materials and methods: The present study was a retrospective and multicentric study, in which all data were reviewed for patients with BC in the central airways, referred to the Thoracic Surgery Units of Luigi Vanvitelli University of Naples and Sant’Andrea Hospital in Rome between October 2012 and December 2022 Overall, 35 patients, 13 of whom were female, were included in the study (median age, 53 years; range, 29–75 years). All patients underwent rigid bronchoscopy combined with flexible bronchoscopy. Tumor clearance was mostly performed by use of Argon Plasma Coagulation or Thulep Laser, mechanical debridement and excision with the use of forceps and aspirator through the working channel of the 8.5 mm-sized rigid bronchoscope. There were no complications during the treatment. Results: Endobronchial treatment provided complete tumor eradication in all patients; two patients had controlled bleeding complications; however, bleeding was well controlled without patient desaturation, and only one patient died of renal failure during the follow-up period. We found two recurrences in the left and right main bronchus, in patients with atypical carcinoma during fiberoptic bronchoscopy follow-up. Only one patient died of renal failure. At the first analysis, there were no significant differences between the patients receiving endobronchial treatment and patients receiving surgical treatment in the present study (p-value > 0.05—it means statistically insignificant). Conclusions: Endobronchial treatment is a valid and effective alternative for patients with BC unsuitable for surgery.

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“…The healing of the damaged region can result in web-like fibrosis within 3–6 weeks; healing determines the formation of a solid fibrous scar responsible for various degrees of stenosis; concentric stenosis is the most common finding [ 2 , 3 ]. During the bronchoscopic examination, the characteristics of the stenosis were assessed: “Complex stenosis” showed the presence of stenosis segments > 1 cm, malacia, cartilage involvement, and inflammation, while “Simple stenosis” showed the presence of stenosis segments < 1 cm, with involvement limited to the mucosa and absence of malacia and cartilage loss [ 4 ]. Bronchoscopic treatment is preferred for simple stenosis, while tracheal sleeve resection may be required for complex lesions [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…All patients were undergoing diagnostic preliminary flexible bronchoscopy, defining type, the localization, and severity of the tracheal stenosis. The type of stenosis was classified as simple, complex or mixed based on the length and the involvement of the tracheal wall cartilages [ 4 ] (Fig. 1 ).…”

Section: Introductionmentioning

confidence: 99%

Modified blade: an interventional option in rigid bronchoscopy for non-resectable benign tracheal stenosis

Messina,

Di Filippo,

Capasso

et al. 2024

J Cardiothorac Surg

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Introduction Benign tracheobronchial stenosis is a abnormal tracheal lumen narrowing that may incur progressive dyspnea and life-threatening hypoxemia. There is no consensus on which patients should be treated with endoscopic or surgical method. This study investigates the outcomes of bronchoscopic dilatation in the treatment of benign tracheal stenosis using a device equipped with a blade to cut the stenotic lesions with dense fibrosis. Materials and methods The procedure was carried out in an operating room under general anesthesia. All patients were intubated with a Rigid Bronchoscope (RB) placed just above the stenosis. Through Rigid Bronchoscopy combined modalities were used as needed: radial incisions of the mucosal stenosis with blade at the levels of 4, 8 and 12 o’clock, with back and forth movements, then the stenotic area was dilated more easily with a rigid bronchoscope. Dilatation was performed by passing the RB of increasing diameter through stenotic areas and then Balloon dilatation of increasing diameter. There were no complications during the procedure. Result We conducted an observational, retrospective, single-centre study in the Thoracic Surgery Unit of the University of ‘Luigi Vanvitelli’ of Naples from November 2011 to September 2021. We included all consecutive patients with benign tracheal stenosis inoperable. During the study period, 113 patients were referred to our department with benign tracheal stenosis inoperable. 61 patients were treated with the blade. During the follow-up, a recurrence of the stenosis was observed in 8 patients in the first month and in 4 patients in the third month. Instead in the patients treated with the use of laser (52 patients), during the follow-up a recurrence was observed in 16 patients in the first month and in 6 patients in the third month; no patient relapsed after 6 months and after 1 year. Long term successful bronchoscopic management with blade was attained by 99% in simple and 93% in mixed stenosis and in complex type stenosis. Conclusion Our study underlines the importance of the use of the blade in bronchoscopic treatment as a valid conservative approach in the management of patients with inoperable benign tracheal stenosis as an alternative to the use of the laser, reducing the abnormal inflammatory reaction in order to limit recurrences.

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Endobronchial Ultrasound for Benign Tracheal Stenosis

Cited by 6 publications

References 5 publications

Comparison of two different flexible laryngeal airway masks in pediatric ophthalmic surgeries: A retrospective study

Comparison of two different flexible laryngeal airway masks in pediatric ophthalmic surgeries: A retrospective study

Advances in Endoscopic Management of Endobronchial Carcinoid

Modified blade: an interventional option in rigid bronchoscopy for non-resectable benign tracheal stenosis

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