The clinical feasibility of flexible bronchoscopy interventional therapy in patients with central airway stenosis and respiratory failure caused by malignancy

Wang, Jiwang; Yang, Yang; Zha, Wangjian; Zhang, Xiuwei

doi:10.2147/ott.s175825

Cited by 3 publications

(5 citation statements)

References 15 publications

(11 reference statements)

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“…Similar to the study reported by Ong, this study showed that patients with a high ECOG PS score [ 3 , 4 ] had a worse prognosis than patients with a low ECOG PS score [0–2] (the mean survival time was 3.85 months and 12.35 months, resp., P =0.004), indicating that patients with good PS might survive from stent implantation to prolong survival and improve oxygenation [ 19 ]. Stent placement has been proven to prevent acute asphyxia, reduce the patient's fear of sudden death, and provide patients with enough time to receive additional treatments, such as chemotherapy, radiotherapy, and palliative care [ 20 ]. Indications of airway stent implantation should be determined carefully for patients with poor PS.…”

Section: Discussionmentioning

confidence: 99%

Clinical Study of Airway Stent Implantation in the Treatment of Patients with Malignant Central Airway Obstruction

Xing

Zeng

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Background. Airway stenting is a therapeutic option for malignant central airway obstructions (MCAO), including both intraluminal and extraluminal obstructions. The objective of this study is to investigate the clinical features and results of long-term improved prognosis for MCAO patients after airway stent implantation. Methods. Ninety-eight MCAO patients who underwent stent placement in our hospital from January 2013 to April 2020 were included in this study. The data included baseline data, clinical characteristics, laboratory test data, stent implantation data, and treatment as well as survival after stent implantation. The survival rates among individuals were compared via log-rank tests. Potential prognostic factors were identified using multivariate cox hazard regression models. Results. A retrospective analysis of these patients was generated. MCAO was mainly caused by lung cancer (53/98, 54.08%), esophageal cancer (22/98, 22.45%), and thyroid cancer (3/98, 3.06%). The median survival time of participants was 5.5 months. Univariate analysis indicated that the survival rate was related to primary disease, ECOG PS score, stent site, hemoglobin (Hb), albumin (ALB), and serum lactate dehydrogenase (LDH) ( P < 0.05 ). The cox risk regression model showed that the survival rate was significantly influenced by ECOG PS score (OR = 3.468, 95%CI = 1.426–8.432, P = 0.006 ) and stent site (OR = 1.544, 95%CI = 1.057–2.255, P = 0.025 ). Conclusions. Compared with the site of stent placement, the ECOG PS score is the primary factor in the survival rate of MCAO patients after airway stenting.

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Section: Discussionmentioning

confidence: 99%

Clinical Study of Airway Stent Implantation in the Treatment of Patients with Malignant Central Airway Obstruction

Xing

Zeng

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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“…For balloon dilation, Quantum maverick balloon catheter (Boston Scientific Corporation) was positioned within the stenotic area of the airway under flexible bronchoscopy visualization. The diameter of the balloon and expansion pressure were gradually increased depending on the diameter and length of the airway stenosis 10 . During the treatment, the balloon was inflated for 30–120 s with the expansion pressure 3–8 atm (balloon diameter: 3–5 mm) to dilate the airway.…”

Section: Methodsmentioning

confidence: 99%

“…Then carbon dioxide (CO 2 ) cryotherapy was undertaken in an attempt to ablate the residual granulation tissue and minimize recurrence of granulation tissue or scarring. For CO 2 cryotherapy, a cryo‐probe of 1.9 mm diameter (Erbokryo CA; Erbe) with CO 2 as cryogen was applied on the residual granulation tissue for 30 to 60 s, and these steps were repeated as required 9,10 . Sometimes, a biopsy forceps failed to removal of the lesion, because granulation, mucosal trauma, and multifactorial inflammation‐fibrosis cycle can lead to cicatrization 11 .…”

Section: Methodsmentioning

confidence: 99%

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Interventional therapy via flexible bronchoscopy in the management of foreign body‐related occlusive endobronchial granulation tissue formation in children

Zhou

et al. 2020

Pediatric Pulmonology

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Background Occlusive granulation tissue formation, as one of the most common sequelae of chronic foreign body aspiration, can cause tracheobronchial obstruction and delayed fixed airway stenosis necessitating interventions. The aim of this study was to explore the clinical efficacy and safety of interventional therapy via flexible bronchoscopy for treatment of granulation tissue related airway obstruction secondary to foreign body aspiration in children. Method Patients with long‐term foreign body related granulation tissue were treated with flexible bronchoscopy therapeutic modalities, including forceps, cryotherapy, holmium laser, and balloon dilatation. Clinical efficacy was evaluated by clinical symptoms and endoscopic manifestations. Results A total of eight patients with granulation tissue hyperplasia caused by foreign body in bronchus, with a median age of 29.5 (range, 18–54) months, underwent interventional therapy between January 2016 and December 2019. Four patients received forceps and CO2 cryotherapy and one patient required forceps only. The remaining three patients received holmium laser combined with CO2 cryotherapy, and one of them required additional balloon dilatation. Four cases required a second cryotherapy procedure, and one case received three cryotherapy procedures for extensive granulation tissue. The treatment efficacy was 100% without complications. Conclusion Interventional procedure via flexible bronchoscopy is a safe, reliable, and effective method in the management of tracheobronchial obstruction and stenosis caused by foreign body‐related granulation tissue hyperplasia. It is worthy of clinical application.

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“…Central airway obstruction (CAO) caused by intraluminal spherical masses is relatively rare and can be caused by multiple benign or malignant lesions that are easily misdiagnosed or missed. Due to the specific lesion site, many patients have urgent, critical symptoms at the time of treatment, and the disease progresses so quickly that the patients are prone to asphyxia; therefore, substantial attention should be paid to these lesions [1]. Intraluminal central airway masses vary in shape; most are irregular, but spheroid masses are occasionally encountered.…”

Section: Introductionmentioning

confidence: 99%

Aetiologic Diagnosis and the Efficacy of Interventional Treatment of Intraluminal Central Airway Spheroid Masses

Song¹,

Zha²,

Wang³

2020

SJCM

Self Cite

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Objective To explore the diagnosis of, clinical characteristics of and effects of interventional therapy for intraluminal central airway spheroid masses. Methods Forty-four patients with intraluminal central airway spheroid masses were summarized retrospectively, and the clinical characteristics and therapy were analysed. Results Cough and shortness of breath were the predominant symptoms, followed by hemoptysis, fever and chest pain. The aetiologic diagnoses were 12 cases of inflammatory granulomas, 5 cases of foreign matter, 5 cases of squamous carcinoma, 4 cases of leiomyoma, 3 cases of lipomyoma, 2 cases of inflammatory myofibroblastic tumor, and one case each of glomus tumor, adenocarcinoma, mucoepidermoid carcinoma, malignant melanoma metastasis, carcinoid, adenoid cystic carcinoma, chondrosarcoma, combined small cell carcinoma, hamartoma, mixed tumor, neurilemmoma, acidophilic adenoma and salivary gland tumor. The numbers of masses located in the trachea, left main bronchus, right main bronchus and bronchus intermedius were 20, 13, 7, and 4, respectively. Electrocautery snare and electrocoagulation probe was the most commonly used interventional therapy method, followed by argon plasma coagulation and cryotherapy; stent implantation was used in 1 case. Thirty-five cases achieved a complete response or partial response after treatment, 8 cases achieved a mild response, and 1 had no response. Conclusion The symptoms of intraluminal central airway spheroid masses were atypical and easily misdiagnosed or missed; benign lesions were the leading cause, and the first pathological type was inflammatory granuloma. Endoscopic intervention was the effective, safe technique.

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The clinical feasibility of flexible bronchoscopy interventional therapy in patients with central airway stenosis and respiratory failure caused by malignancy

Cited by 3 publications

References 15 publications

Clinical Study of Airway Stent Implantation in the Treatment of Patients with Malignant Central Airway Obstruction

Clinical Study of Airway Stent Implantation in the Treatment of Patients with Malignant Central Airway Obstruction

Interventional therapy via flexible bronchoscopy in the management of foreign body‐related occlusive endobronchial granulation tissue formation in children

Aetiologic Diagnosis and the Efficacy of Interventional Treatment of Intraluminal Central Airway Spheroid Masses

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