Laser treatment for carcinoma of the bronchus.

Hetzel, M; Millard, F. J. C.; Ayesh, R; Bridges, C E; Nanson, Eric M.; Swain, C. Paul; Williams, I P

doi:10.1136/bmj.286.6358.12

Cited by 68 publications

(17 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, care must be taken to avoid spillage of pus after relief of obstruction. Hetzel and associates [63] reported that reexpansion of completely collapsed lung led to fatal pneumonia in 2 of 3 patients.…”

Section: Airway Obstructionmentioning

confidence: 98%

Critical Care of Intrathoracic Complications of Lung Cancer

Schultz

Murren

1994

J Intensive Care Med

View full text Add to dashboard Cite

JR Critical care of intnthoracic complications of lung cancer. J Intensive Care Xled 1994;998-113.Lung cancer is the most common underlying malignancy in cancer patients admitted to intensive care units. Because of the proximity to vital organs in the mediastinum, lung cancer frequently causes complications requiring critical care, including cardiac tamponade, central airway obstruction, massive hemopytsis. and superior vena caw syndrome. In addition, radiation and chemotherapeutic agents used to treat lung cancer may cause lifethreatening pneumonitis in a minority of patients. There are several management options available for each complication. Educated decisions must be made based on individual patient circumstances. Technological advances have allowed for successful treatment of the majority of patients with such complications.For example, photoresection with the NdYAG laser can relieve dyspnea in 87% of patients with airway obstruction; hemorrhage can be controlled 80% of the time with bronchial artery embolization; and symptoms of superior vena cam syndrome may be relieved in more than 90% of patients. Although the median survival of cancer patients admitted to the intensive care unit is relatively short, such interventions can effectively palliate symptoms and may prolong sun.ival.Lung cancer is the most common underlying malignancy in cancer patients admitted to intensive care units (ICUs) [l]. This finding is related to several factors. Lung cancer is the leading cause of cancer death in both men and women in the United States, with an estimated incidence in 1993 of 170,000 cases [2]. Because of the proximity to vital organs in the mediastinum, lung cancer frequently causes lifethreatening complications requiring critical care. Local complications of intrathoracic tumor are the most common cause of death in patients with nonsmall-cell lung cancer (NSCLC) [3]. Furthermore, among patients with small-cell lung cancer (SCLC), local recurrence develops in as many as 50% [4].Critical care of cancer patients often presents an ethical dilemma. In comparison to critically ill patients without malignancy, cancer patients in the ICU have a significantly higher mortality rate. The overall mortality of cancer patients admitted to the ICU for all causes ranges from 22 to 55% [l, 5-81. The most common cause of death is the adult respiratory distress syndrome (ARDS), with or without infection. In one study, only 12% of deaths were caused directly by the malignancy [7]. hlonality rates are particularly high for cancer patients with respiratory failure requiring mechanical ventilation (1,5,(8)(9)(10). Ewer and colleagues [ 9 ] evaluated 46 consecutive patients with lung cancer who required mechanical ventilation and found that only 4 (9%) survived to leave the hospital. Similarly, Ludwig and associates [ 101 found an 84% in-hospital mortality rate for ventilatory-supported cancer patients. In addition, the majority of patients with solid tumors spend less than 3 months at home after surviving to leave the hospital [5].Non...

show abstract

Section: Airway Obstructionmentioning

confidence: 98%

Critical Care of Intrathoracic Complications of Lung Cancer

Schultz

Murren

1994

J Intensive Care Med

View full text Add to dashboard Cite

show abstract

“…Recently local, palliative laser treatment of endobronchial carcinoma via the fibrescope has been assessed (Hetzel et al, 1983). In 34 patients, good palliation was achieved in just over 50o.…”

Section: Therapeutic Bronchoscopymentioning

confidence: 99%

Current status of fibreoptic bronchoscopy

Dhillon¹,

Collins²

1984

Postgraduate Medical Journal

View full text Add to dashboard Cite

“…However, in the latter situation fulminating infections have occurred perhaps due to aspiration of the trapped contents distal to the blockage (Hetzel et al, 1983).…”

Section: Cytotoxic Chemotherapymentioning

confidence: 99%