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KMID : 0364020080410040457
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Korean Journal of Thoracic and Cardiovascular Surgery
2008 Volume.41 No. 4 p.457 ~ p.462
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Clinical Appilication of Endobornchial Cryoablation That’s Performed through Flexible Bronchoscope for Treating Tracheobronchial Ostruction
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Lee Sung-Ho
Kim Kwang-Taik
Chung Jae-Ho
Chung Won-Jae
Kang Moon-Chul
Kang Eun-Hae
Lee Eun-Joo
In Kwang-Ho
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Abstract
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Background: Emergency airway access is essential when a patient has dyspnea that’s due to tracheal or bronchial obstruction. Such methods as laser therapy and PDT are now being used for the treatment of tracheal obstruction that’s due to benign diseases or nonsurgical malignant diseases. Cryotherapy is a method that uses extreme hypothermia for freezing a tumor to cause necrosis. In this study, we have evaluated the clinical effectiveness of performing endobronchial cryoablation through a flexible bronchoscope.
Material and Method: 10 patients with tracheal obstruction that was due to endotracheal tumors were evaluated between May 2005 and May 2007. Eight were male and the mean age of the 10 patients was 59.4±18.4 years. Three cases of tracheal obstruction were due to benign tumors and 7 were due to malignant tumors. The obstruction sites were 3 at the trachea, 3 at the carina and 4 at the bronchus. A flexible bronchoscope was inserted and the tumor was eliminated using a flexible cryoprobe. Follow up bronchoscopy was performed at 1 week and 1 month after cryoablation, and then we evaluated the decrease of dyspnea, the improvement of the performance and the complications of the procedures.
Result: Complete remission was achieved in 4 patients and partial remission was achieved in 6 patients. Complications such as hemoptysis (100%), and cough (50%) were noted. Hemoptysis was spontaneously resolved in 3 to 8 days (mean: 4.9 days). A decrease in dyspnea and improvement in the performance was noted in all patients.
Conclusion: Endobronchial stenosis plays a detrimental role in the life quality of a terminal cancer patient. Due to its simplicity and effectiveness for controlling bleeding, endobronchial cryoablation is considered to be a safe method that is clinically applicable to a wide range of tumors, including the removal of large tumors. We concluded that endobronchial cryoablation through a flexible bronchoscope is a safe, effective method for treating tracheobroncheal obstructions. (Korean J Thorac Cardiovasc Surg 2008;41:457-462)
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KEYWORD
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Bronchialtumor, Bronchoscopy, Cryosurgery, Trachealstenosis, Bronchialstenosis
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