Endobronchial management of malignant central airway obstruction: the first 6-year single center experience

Yıl 2019, Cilt: 5 Sayı: 5, 879 - 885, 04.09.2019

Zafer Aktaş Aydın Yılmaz Ayperi Öztürk Yusuf Taha Güllü Mevlüt Karataş

https://doi.org/10.18621/eurj.556443

Cited By: 1

Öz

Objectives:
Central
airway obstruction (CAO) develops in 20-30% of lung malignancies during the
disease. The symptoms related to obstruction often result in poor quality of
life and poor prognosis. Interventional bronchoscopic treatments are now
recommended in guidelines to improve quality of life and symptom palliation in
this patient group. In our study, we aimed to determine the efficacy and safety
of our methods in the malignant CAO caused by endobronchial exophytic tumors.

Methods: Between
May 2012 and August 2018, 432 endobronchial debulking procedures were performed
in 388 patients with symptomatic malignant CAO due to endobronchial exophytic
or mixed lesions.

Results: Primary
lung tumors were the most common cause of airway stenosis (84.0%). The most
common debulking technique was argon plasma coagulation assisted mechanical
debridement (APC+MD) (79.9%). Airway patency was achieved with additional
stents (10.2%) in the operations. The success rate of airway patency was 85.5%
in APC+MD method, 75.6% in cryorecanalisation method, 91.7% in electrocautery
assisted MD method, 100% in MD method and overall success rate was 85.4%. Stent
use rate was significantly higher in the stenosis around main carina (42.9%)
than in other localizations (p < 0.001).
The overall serious complication rate was 2.1%. Procedure-related dead rate was
0.2%.

Conclusions: Endobronchial
treatment of malignant CAO with interventional bronchoscopic procedures is
effective and safe. The first 6 years of experience in our interventional
pulmonary clinic show that it has similar characteristics with the world
experience in the endobronchial treatment of malignant CAO. 

Anahtar Kelimeler

Interventional bronchoscopy, debulking, malignant central airway obstruction

Kaynakça

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