Integration of interventional bronchoscopy in the management of lung cancer

Guibert, Nicolas; Mazières, Julien; Marquette, Charles-Hugo; Rouvière, Damien; Didier, A.; Hermant, Christophe

doi:10.1183/16000617.00010014

Cited by 38 publications

(29 citation statements)

References 118 publications

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“…Extraluminal Mixed airway stenting is also useful in preventing recurrence and restore the airway patency after intraluminal tumor debulking (25). The choice of techniques depends on the characteristics of stenosis, the condition of patient, available techniques and the operator's expertise ( Table 1).…”

Section: Intraluminalmentioning

confidence: 99%

“…Although they suggested that mechanical debulking under rigid bronchoscopy was probably quicker than thermal ablative therapy, there was no direct comparison of procedure time between difference methods. Combining mechanical debulking with a complementary thermal ablative procedure may be a safer choice in bleeding control (25).…”

Section: Rigid Bronchoscopy and Mechanical Debulkingmentioning

confidence: 99%

“…It can be introduced with rigid or flexible bronchoscopy. The effect of cryotherapy is usually delayed but prolonged, with capillary microthrombi formation (25). The efficacy depends on the cooling rate, the minimum temperature reached, the cycle of freezing and thaw (22).…”

Section: Cryotherapymentioning

confidence: 99%

“…The endobronchial stent is the main choice to alleviate extraluminal airway compression and is also available to relieve intraluminal and mixed type central airway obstruction when combining with other endobronchial therapies (25). Airway stent is usually a palliative treatment for malignancy.…”

Section: Stentmentioning

confidence: 99%

“…The size, length and diameter are chosen preoperatively and can be adjust by cutting. Because it is easy to insert and remove, with few granulomatous reactions, silicone stent has been recommended as first line treatment and is particular suitable for benign lesion for the longer lifespan (25).…”

Section: Silicone Stentsmentioning

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: Intraluminalmentioning

confidence: 99%

Section: Rigid Bronchoscopy and Mechanical Debulkingmentioning

confidence: 99%

Section: Cryotherapymentioning

confidence: 99%

Section: Stentmentioning

confidence: 99%

Section: Silicone Stentsmentioning

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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Rolle der Strahlentherapie bei onkologischen Notfällen

et al. 2020

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Evaluating the interaction of a tracheobronchial stent in an ovine in-vivo model

McGrath

Thiebes

Cornelissen

et al. 2017

Biomech Model Mechanobiol

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Tracheobronchial stents are used to restore patency to stenosed airways. However, these devices are associated with many complications such as stent migration, granulation tissue formation, mucous plugging and stent strut fracture. Of these, granulation tissue formation is the complication that most frequently requires costly secondary interventions. In this study a biomechanical lung modelling framework recently developed by the authors to capture the lung in-vivo stress state under physiological loading is employed in conjunction with ovine pre-clinical stenting results and device experimental data to evaluate the effect of stent interaction on granulation tissue formation. Stenting is simulated using a validated model of a prototype covered laser-cut tracheobronchial stent in a semi-specific biomechanical lung model, and physiological loading is performed. Two computational methods are then used to predict possible granulation tissue formation: the standard method which utilises the increase in maximum principal stress change, and a newly proposed method which compares the change in contact pressure over a respiratory cycle. These computational predictions of granulation tissue formation are then compared to pre-clinical stenting observations after a 6-week implantation period. Experimental results of the pre-clinical stent implantation showed signs of granulation tissue formation both proximally and distally, with a greater proximal reaction. The standard method failed to show a correlation with the experimental results. However, the contact change method showed an apparent correlation with granulation tissue formation. These results suggest that this new method could be used as a tool to improve future device designs.

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Integration of interventional bronchoscopy in the management of lung cancer

Cited by 38 publications

References 118 publications

Central airway tumors: interventional bronchoscopy in diagnosis and management

Central airway tumors: interventional bronchoscopy in diagnosis and management

Rolle der Strahlentherapie bei onkologischen Notfällen

Evaluating the interaction of a tracheobronchial stent in an ovine in-vivo model

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