- Bronchology
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Sequential use of cryoextraction postelectrocautery for airway recanalization using fiberoptic bronchoscopy
Egyptian Journal of Bronchology volume 9, pages 269–275 (2015)
Abstract
Background
Airway obstruction presents with dyspnea, cough, hemoptysis, and atelectasis. Removing or decreasing the size of the obstructing lesions improves patient’s symptoms and life quality.
Aim
Assessing the efficacy and safety of sequential use of cryoextraction and electrocautery in achievement of airway patency using fiberoptic bronchoscopy (FOB).
Patients and methods
This study was conducted at the Chest Medicine Department, Mansoura University, Egypt and included 22 patients with central airway obstruction (15 males and seven females) with a mean age of 50.5 ± 18.3 years. After etiologic diagnosis of airway obstruction, they were divided into two groups: group A (nonmalignant); eight patients and group B (malignant); 14 patients. All patients were subjected to sequential use of cryoextraction after electrocautery. Operable, unfit patients or patients with extraluminal obstruction were excluded. Clinical, radiological, functional, and bronchoscopic data were evaluated before and after FOB.
Results
The improvement in performance scale was highly significant in group B (P < 0.001) and significant in group A (P = 0.001). Spirometric parameters improved in both groups but were highly significant in group B (P < 0.001). Radiological improvement occurred in four out of eight of group A and in three out of 14 of group B. FOB score improved in group B (P = 0.003) and was more significant in group A. The procedure was complicated with atrial fibrillation and hemoptysis in one case and postbronchoscopy hypoxemia in two cases with no deaths.
Conclusion
Cryoextraction after electrocautery using FOB are effective, safe, easy, and cheap in achieving airway patency. Egypt J Broncho 2015 9:269–275
References
Lee P, Tamm M, Chhajed PN. Advances in bronchoscopy –therapeutic bronchoscopy. J Assoc Physicians India 2004; 52:905–914.
Kupeli E, Karnak D, Mehta AC. Flexible bronchoscopy. In: Mason RJ, Murray JF, Broaddus VC, Nadel JA, Martin RT, King TE, Talmadge E, Schraufnagel DE, editors. Murray and Nadel’s textbook of respiratory medicine. 5th ed. USA: Elsevier; 2010. –331.
Lahm T, Sheksi FD. Update on cryotherapy, brachytherapy, and photodynamic therapy. In: Mathur P, Mehta AC, Beamis J, editors. Interventional pulmonary medicine. 5th ed. USA: Informa Healthcare; 2010. 230:–44.
Altin S, Dalar L, Karasulu L, Cetinkaya E, Timur S, Solmazer N. Resection of giant endobronchial hamartoma by electrocautery and cryotherapy via flexible bronchoscopy. Tuberk Toraks 2007; 55:390–394.
Koletsis EN, Prokakis C, Karanikolas M, Apostolakis E, Dougenis D. Current role of surgery in small cell lung carcinoma. J Cardiothorac Surg 2009; 4:30–34.
American Thoracic Society. Dyspnea: mechanisms, assessment and management a consensus statement. Am J Respir Crit Care Med 1999; 159:321–340.
Walsh DA, Maiwand MO, Nath AR, Lockwood P, Lloyd MH, Saab M. Bronchoscopic cryotherapy for advanced bronchial carcinoma. Thorax 1990; 45:509–513.
Speiser B, Spratling L. Remote after loading brachytherapy for the local control of endobronchial carcinoma. Int J Radiat Oncol Biol Phys 1993; 25:57–67.
Muers MF. Quality of life and symptom control. Eur Respir Monogr 2001; 17:305–329.
Gridelli C, Ardizzoni A, Le Chevalier T, Manegold C, Perrone F, Thatcher N, et al. Treatment of advanced non-small-cell lung cancer patients with ECOG performance status 2: results of an European Experts Panel. Ann Oncol 2004;15:419–426.
Speiser B. Protocol for local control of endobronchial carcinoma using remote after loading HDR brachytherapy. Act Sel Brachyther J 1990; 1:16–19.
Eisenhauer E, Therasse P, Bogaerts J, Schwartz L, Sargent D, Ford R. New response evaluation criteria in solid tumors: revised RECIST guideline. Eur J Cancer 2009; 45:228–247.
Seaman JC, Musani AI. Endobronchial ablative therapies. Clin Chest Med 2013; 34:417–425.
Sutedja G, Postmus PE. Bronchoscopic treatment of lung tumors. Lung Cancer 1994; 11:1–17.
Homasson JP. Endobronchial electrocautery. Semin Respir Crit Care Med 1997; 18:535–543.
Mohammad YA. Evaluation of the role of APC and cryotherapy in management of endobronchial tumors MD thesis]. Egypt: Chest Department, Faculty of Medicine, Assiut University; 2007
AbdelSalam N. Argon plasma coagulation versus chemotherapy in palliative treatment of inoperable non-small cell lung cancer MD Thesis]. Egypt: Chest Department, Faculty of Medicine, Mansoura University; 2005
Asimakopoulos G, Beeson J, Evans J, Maiwand MO. Cryosurgery for malignant endobronchial tumors: analysis of outcome. Chest 2005; 127:–2014.
Maiwand MO. Endobronchial cryosurgery. Chest Surg Clin N Am 2001; 11:791–811.
Maiwand MO, Asimakopoulos G. Cryosurgery for lung cancer: clinical results and technical aspects. Technol Cancer Res Treat 2004; 3:143–150.
Hussein RM, Korraa EA, Fawzy MA, Sileem AE. Prognostic factors for bronchoscopic electrocautery and/or argon plasma coagulation in patients with central airway obstruction. Egypt J Chest Dis Tuberculosis 2013; 62:501–511.
Amer WM, Kamel KM, El-Shahat HM, Nafea RM. Role of electrocautery and argon plasma coagulation in management of endobronchial neoplasms. Zagazig Univ Med J 2012; 18:80–86.
Sutedja G, van Kralingen K, Schramel F, Postmus PE. Fiberoptic bronchoscopic electrosurgery under local anaesthesia for rapid palliation in patients with central airway malignancies: a preliminary report. Thorax 1994; 49:1243–1246.
Ledingham SJ, Goldstraw P. Diathermy resection and radioactive gold grains for palliation of obstruction due to recurrence of bronchial carcinoma after external irradiation. Thorax 1989; 44:48–51.
Safwat T, Hosny M, Korraa M, Madkour A, Elghazaly H, Ali T. The efficacy of bronchoscopic intratumoral chemotherapy in palliation of inoperable lung cancer: initial Egyptian experience. Egypt J Bronchol 2011; 5:96–104.
Sindhwani G, Rawat J, Keserwani V. Role of endobronchial electrocautery in management of neoplastic central airway obstruction: initial experience with seven cases. Indian J Chest Dis Allied Sci 2012; 54:165–168.
Hetzel M, Hetzel J, Schumann C, Marx N, Babiak A. Cryorecanalization: a new approach for the immediate management of acute airway obstruction. J Thorac Cardiovasc Surg 2004; 127:1427–1431.
Coulter TD, Mehta AC. The heat is on: impact of endobronchial electrosurgery on the need for Nd-YAG laser photoresection. Chest 2000; 118:516–521.
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El Badrawy, M.K., Shalabi, N.M., Hewidy, A.A. et al. Sequential use of cryoextraction postelectrocautery for airway recanalization using fiberoptic bronchoscopy. Egypt J Bronchol 9, 269–275 (2015). https://doi.org/10.4103/1687-8426.165920
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DOI: https://doi.org/10.4103/1687-8426.165920