The technique of endoscopic airway tumor treatment

Scarlata, Simone; Fuso, Lello; Lucantoni, Gabriele; Varone, Francesco; Magnini, Daniele; Incalzi, Raffaele Antonelli; Galluccio, Giovanni

doi:10.21037/jtd.2017.07.68

Cited by 42 publications

(16 citation statements)

References 103 publications

(102 reference statements)

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“…Opening of the narrow trachea as soon as possible is one of the key factors affecting the prognosis of the disease [8]. Although there has been considerable progress in recent years in terms of the development of bronchoscopy interventional techniques, including electrocoagulation, APC, airway stenting, balloon dilatation, laser therapy and cryoablation, the critical management of some patients with obstruction of the distal section of the central airway caused by intraluminal tumour growth or extrinsic compression is difficult and remains a focus of attention [9].…”

Section: Discussionmentioning

confidence: 99%

Implantation of 125I radioactive seeds via c-TBNA combined with chemotherapy in an advanced non-small-cell lung carcinoma patient

Jiang

Zhang

2019

BMC Pulm Med

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BackgroundThe critical management of advanced non-small-cell lung carcinoma (NSCLC), especially when complicated by severe airway stenosis, is difficult and often leads to high clinical risks and medical costs.Case presentationA 51-year-old previously healthy male was admitted to the Department of Respiratory and Critical Care Medicine, Taizhou People’s Hospital, in November 2018 for haemoptysis and difficulty breathing during a 15-d period. Following admission, chest computed tomography (CT) showed a large mass in the left hilum with atelectasis in the left upper lobe and obstructive pneumonia in the left lower lobe. Bronchoscopy revealed that the lesions occurred in the distal segment of the left main trachea, with occlusion of the left upper bronchus and significant narrowing of the lower bronchus. A basal mucosal biopsy of the lump tissue was performed after haemostasis treatment with sub-plasma coagulation (APC), and squamous lung carcinoma was confirmed. Following the final diagnosis, the patient was successfully treated with implantation of 125I radioactive seeds via transbronchial needle aspiration (c-TBNA) combined with chemotherapy.ConclusionWe believe that implantation of 125I radioactive seeds via c-TBNA is an effective treatment for patients with advanced lung cancer and those presenting with severe and mixed main bronchus stenosis.

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Section: Discussionmentioning

confidence: 99%

Implantation of 125I radioactive seeds via c-TBNA combined with chemotherapy in an advanced non-small-cell lung carcinoma patient

Jiang

Zhang

2019

BMC Pulm Med

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“…[8] Many interventional bronchoscopic options exist, such as laser, electrocautery, cryotherapy, argon plasma coagulator, photodynamic therapy, among many others. [1–4,8,10]…”

Section: Discussionmentioning

confidence: 99%

“…Laser has been well-reported for treating tumors obstructing the central airway and benign airway stenosis. [1,3,4,8–10] A noncontact light energy is delivered via a catheter, providing a better control of bleeding in the airway. Of several different types of lasers, the neodymium:yttrium aluminum garnet (Nd:YAG) laser is the best described for either rigid or flexible bronchoscopy.…”

Section: Discussionmentioning

confidence: 99%

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Bronchoscopic cryosurgery for metastatic tumor causing central airway obstruction

Chen¹,

Goan²,

Tang³

et al. 2019

Medicine

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Rationale:Bronchoscopic cryotherapy has been considered as one of the optional interventions for unresectable malignant central airway obstruction (CAO). And it provides high safety and effectiveness in airway patency re-establishment. This report describes the interventional bronchoscopic cryotherapy for a patient with CAO caused by squamous cell carcinoma of the esophagus. We display a series of dramatic change of chest radiographs before and after the intervention.Patient concerns:A 70-year-old man with squamous cell carcinoma of the middle third of the esophagus (initial staging, pT2N0M0; stage IIB; in January 2017) underwent Video-assisted esophagectomy and reconstruction with a gastric conduit via a substernal route. Following Chest computed tomography and positron emission tomography revealed disease progression with paratracheal metastases. Progressive dyspnea and chest pain lasted for a month, and he was admitted to the ER.Diagnoses:Blood gas analysis revealed type I respiratory failure (pH, 7.445; PaO2, 69.4 mmHg; PaCO2, 40.6 mmHg). Other laboratory data were grossly normal. Chest radiography revealed a total left lung collapse. Chest CT identified a tumor blocking the left mainstem bronchus with the consolidation of the left lung.Interventions:Dexamethasone and epinephrine inhalation were administered for initial symptom relief. Bronchoscopy performed 4 days after admission revealed a huge tumor completely occluding the left mainstem bronchus orifice. The occlusion was completely resolved following cryotherapy. Then, the first course of palliative chemotherapy with cisplatin plus fluorouracil, followed by the second course a month later, was administered.Outcomes:The latest chest radiograph showed a patent airway. The patient's condition remained stable for at least the following 2 months.Lessons:Malignant CAO is a rare but potentially life-threatening condition. Several acceptable bronchoscopy techniques exist for treatment. Cryotherapy has high safety and effectiveness in airway patency re-establishment.

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“…Many useful interventional bronchoscopic techniques have been developed to treat the endoluminal exophytic part of the malignant tumor causing airway obstruction, such as mechanical debridement, laser, electrocautery, argon plasma coagulation (APC), brachytherapy, photodynamic therapy and cryotherapy (7). The only option for extrinsic compression type stenosis is dilatation and stent placement (8). Malignant involvement of the lower trachea, the main carina, and the mainstem bronchi, often require the placement of a Y stent (9)(10)(11)(12) (Figure 1).…”

Section: Introductionmentioning

confidence: 99%

Complications of silicone Y stents placed due to malignant airway stenosis

Aktaş¹,

Öztürk²,

Yılmaz³

et al. 2019

Tuberk Toraks

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Complications of silicone Y stents placed due to malignant airway stenosis Introduction: Malignant central airway obstruction around the main carina often requires placement of Y-shaped stents. In this study, we aimed to determine the safety of silicone Y stents placed around the main carina in the malignant airway obstruction by examining the long term complications, emergence times and treatment approaches of complications. Materials and Methods: Between May 2012 and July 2015, 47 silicone Y stents were placed in 46 patients with malignant external compression or mixed type stenosis around the main carina. Patient stents were placed via rigid bronchoscopy under total intravenous anesthesia in operating room conditions. results: In the half of the patients (23/46), stents were placed under urgent conditions due to acute respiratory failure. Stents were deployed successfully in all the patients. No procedure related deaths were observed. The median time of survival following stent insertion was 157 days. The total long-term complication rate of silicone Y stents was 28.3%. Mucostasis (8.7%) and migration (2.2%) were observed within the first month after placement of the silicone Y stents (median 18 days), stent-edge granulation tissue development (13.0%) was observed at the earliest one month (median 64, range 34-386 days) and stent-edge tumor tissue development (4.3%) were observed at the earliest 3 months (median 151, range 85-217 days). A total of 7 (15.2%) stents were removed, 2 of which were due to mucostasis and 5 of which were due to granulation tissue development.

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The technique of endoscopic airway tumor treatment

Cited by 42 publications

References 103 publications

Implantation of 125I radioactive seeds via c-TBNA combined with chemotherapy in an advanced non-small-cell lung carcinoma patient

Implantation of 125I radioactive seeds via c-TBNA combined with chemotherapy in an advanced non-small-cell lung carcinoma patient

Bronchoscopic cryosurgery for metastatic tumor causing central airway obstruction

Complications of silicone Y stents placed due to malignant airway stenosis

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