Fibro-bronchoscopic Cryosurgery for Unresectable Endobronchial Tumors
10.3779/j.issn.1009-3419.2014.07.08
- VernacularTitle:不可切除气管、支气管内肿瘤的纤维支气管镜CO2冷冻治疗
- Author:
MA QIANLI
1
;
SHI BIN
;
TIAN YANCHU
;
LIU DERUO
Author Information
1. 中日友好医院胸外科
- Keywords:
Bronchoscopy;
Cryosurgery;
Endobronchial tumor
- From:
Chinese Journal of Lung Cancer
2014;(7):545-549
- CountryChina
- Language:Chinese
-
Abstract:
Background and objective Patients with tracheobronchial tumor are too frail for curative surgical treat-ment, and the original sites are unsuitable for radical resection. hTey always suffered from dyspnea, hymoptosis, obstructive pneumonia, and fever. Airway obstruction has a strong bad impact on the quality of life, and is the main cause of respiratory failure and death. An effective method of palliative is very important. We choose ifbro-bronchoscopic cryosurgery for destruc-tion of endobronchial tumors and analyze the outcomes. Methods Clinical records of 126 cases who under went endobroncho-scopic cryosurgery were reviewed retrospectively from August 2004 to February 2014. Techniques and survival outcomes were analyzed. hTe precise position and length of the cryosurgery was evaluated through three dimension chest computed tomog-raphy (CT) and reconstruction of trachea and bronchus. Local inifltration and general intravenous anesthesia are two options before surgical procedure. Endobronchial tumor was removed by combining two methods of“Cryo-Resecion”and“Cryo-Melt”. Bronchoscopic examination was rechecked 2 weeks later to evaluate if it is necessary to redo the endobronchoscopic cryosur-gery. Results hTe symptoms of cough, short of breath, and hemoptysis were alleviated to different extend. hTe rate of dramati-cally improved and partial improved were 65.1%and 77.0%respectively. hTe mortality is 0.79%. Postoperative Complications included 2 cases of airway bleeding, 4 cases of bronchial stenosis, 2 cases of trachea burning injury, 2 cases of tracheomalacia, and 3 cases of atrium ifbrillation. hTe median survival is 14 months, 1-, 2-, 3-yr survival rates were 58.6%, 24.2%, and 12.2%respectively, based on Kaplan-Meier estimates. Conclusion Endobronchial cryosurgery is an easy and effective minimally invasive choice for controlling and releasing the airway obstructive symptoms resulting from the trachea or bronchial tumors. Besides, the problem of diffcult endotracheal intubation could be resolved atfer removing the tracheal tumor with the beneift of cryotreatment. Some patients could get the chance for further treatment or radical resection. hTerefore, the patients’ quality of life could be improved and the lifetime could be prolonged.
