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KMID : 0383820080640040272
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Tuberculosis and Respiratory Diseases
2008 Volume.64 No. 4 p.272 ~ p.277
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Clinical Benefits and Complications of Cryotherapy in Advanced Lung Cancer with Central Airway Obstruction
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Jung Jin-Yong
Lee Sung-Yong
Kim Dae-Hyun
Lee Kyung-Joo
Lee Eun-Joo
Kang Eun-Hae
Jung Ki-Hwan
Kim Je-Hyeong
Shin Chol
Shim Jae-Jeong
In Kwang-Ho
Kang Kyung-Ho
Yoo Se-Hwa
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Abstract
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Background: The efficacy of the use of the interventional bronchoscope for palliation of patients with central airway
obstruction has been established. In the palliative setting to alleviate central airway obstruction, the use of laser
resection, electrocautery, argon plasma coagulation, photodynamic therapy and cryotherapy can provide relief of
an airway obstruction. Cryotherapy is the therapeutic application of extreme cold for the local destruction of living
tissue. Recently, this technique has been used for endoscopic management of central airway obstructions in Korea.
We report the role and complications of the use of cryotherapy for airway obstructions in patients with advanced
lung cancer.
Methods: We used a flexible cryoprobe for cryotherapy using nitrous oxide as a cryogen. The cryoprobe was
applied through the working channel of a flexible fiberoptic bronchoscope. The temperature of the tip was approximately
?89oC, and the icing time was 5∼20 seconds.
Results: Four patients with a central airway obstruction from advanced lung cancer were treated with cryotherapy.
Three of the four patients were treated successfully and the airway obstruction was improved after the cryotherapy
procedure. Dyspnea, hypoxia and atelectais were improved in three cases. Two patients experienced complications-
one patient experienced pneumomediastinum and the other patient experienced massive hemoptysis during
the cryotherapy procedure. However, these complications resolved and did not influence mortality.
Conclusion: This technique is effective and relatively safe for palliation of inoperable advanced lung cancer with
a central airway obstruction. (Tuberc Respir Dis 2008;64:272-277)
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KEYWORD
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Cryotherapy, Central airway obstruction, Lung cancer
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