240 likes | 320 Vues
OUR ENDOBRONCHIALLY TREATED PATIENTS. Erdoğan Çetinkaya , Mehmet Akif Özgül, Güler Özgül, Ertan Çam, Atayla Gençoğlu, Gülşah Günlüoğlu Yedikule Chest Diseases And Chest Surgery Training and Research Hospital ,. Central airway stenosis.
E N D
OUR ENDOBRONCHIALLY TREATED PATIENTS Erdoğan Çetinkaya, Mehmet Akif Özgül, Güler Özgül, Ertan Çam, Atayla Gençoğlu, Gülşah Günlüoğlu Yedikule Chest Diseases And Chest Surgery Training and Research Hospital ,
Central airway stenosis • Benign or malignant etiology may cause central airway stenosis. • The most common cause of malignant airway stenosis is bronchogenic carcinoma. Thyroid carcinoma and esophageal cancer and occasionally endobronchial metastasis may be the reason. • Granulation tissue due to endotracheal intubation (postintubation stenosis), foreign bodies, tracheobronchomalacia are the main causes of benign airway stenosis
Purpose Method Review of endobronchially treated cases in our clinic between January 2009 and January 2010. Cases have been evaluated retrospectively
Results We studied 57 patients treated endobronchially in our interventional bronchoscopy unit. Average age of the patients were 56 ± 13 , 13 females and 44 males. 42 (73,7%) of the cases were diagnosed with lung carcinoma. 15 (26,3%) had diagnosis of diseases other than lung cancer.
Endobronchial stenosis • Endobronchial stenosis • 12 (21%) by extrinsic lesions, • 33 (57%) intrinsic and • 12 (21%) mixed • Endobronchial stents were placed to 21 (36,8%) of the treated patients. Endobronchial treatment modalities other them stents were performed to 36 (63,2%) of the patients.
Endobronchial treatment 47 sessions of argon plasma coagulation, cryotherapy or combinations were performed. 8 sessions of electrocautery snare, 3 sessions of laser, 21 sessions of stent placement, 5 sessions of stent removal were performed.
Case 1 RK, 62, M DIAGNOSED WITH INOPERABLE LUNG CARCINOMA. HE HAD 4-CYCLE CHEMOTHERAPY AND 75 FRACTIONS OF RADIOTHERAPY. HE WAS ADMİTTED TO OUR CLINIC WITH RECENT SHORTNESS OF BREATH
Case 1 RK
Case 1 RK PET/CT SCANS, BEFORE AND AFTER TREATMENT
Case 1 RK MEDICAL TREATMENT FOLLOWED BY STENT REMOVAL
Case 2 E K, 56, M Shortness of breath, Had no previous history of any lung disease, his complaints progressed for the past 2 years. Referred to our clinic with suspected lung carcinoma
Case 2 E K, 56, M MIXED STENOSIS
Case 2 E K,56 Novatech Dumon Y Stent
Case3 • SD, 49, M • Subdural hematoma, intracerebral hemorrhage after falling from a tree • He was intubated for 10 days in the ICU • History of Type I DM, CAD (13 years) • Smoker 3D, CORONAL BT Complex stenosis
Case 3 SD, 49, M
Case 3 16X14X16 STENOTIC STENT Distal part of the stenotic stent has the diameter of 14 or 16 mm. Distal parts are 15mm long and the stenotic middle part is 20mm long.
Case 3 Dilatation and before stent With stent
Case4 HŞ, 59, M 3 YEARS AGO HE WAS DIAGNOSED WITH INOPERABLE SQUAMOUS CELL LUNG CANCER AFTER BEING INVESTIGATED FOR SHORTNESS OF BREATH AND BACK PAIN.. HE HAD 6-CYCLE CHEMOTHERAPY AND 30 FRACTIONS OF RADIOTHERAPY. IN 2008 PROGRESSION OF HIS DISEASE WAS DETECTED WITH PET/CT SCANS. HE RECEIVED ONLY 3 CYLES OF CHEMOTHERAPY. HE WAS REFERRED TO OUR CLINIC FOR INTERVENTIONAL TREATMENT AND STENTING.
Complications Complications observed were fiberoptic bronchoscopy damage occurred during one session and death of one patient due to respiratory failure not related to our procedure but occurred during endobronchial treatment.
Conclusion Endobronchial treatment is a life saving and effective modality that enhances the quality of life of the patients with air way obstruction.