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- Title
Unimodality and Multimodality Cryodebridement for Airway Obstruction. A Single-Center Experience with Safety and Efficacy.
- Authors
Inaty, Hanine; Folch, Erik; Berger, Robert; Fernandez-Bussy, Sebastian; Chatterji, Sumit; Alape, Daniel; Majid, Adnan
- Abstract
<bold>Rationale: </bold>Cryodebridement (CD) refers to the removal of obstructive material from the lumen of the tracheobronchial tree by freezing with a cryoprobe, which is usually inserted through a flexible bronchoscope. This method of achieving instant recanalization of airways has been established for over 20 years, but published experience comprises limited case series.<bold>Objectives: </bold>This study describes a single large-volume referral center experience, including clinical outcomes and safety profile.<bold>Methods: </bold>Electronic medical records of 156 patients who underwent bronchoscopic CD between December 2007 and March 2012 as the primary method to relieve airway obstruction were reviewed retrospectively.<bold>Measurements and Main Results: </bold>The most frequent cause of airway obstruction was malignancy (n = 88), with non-small-cell lung cancer and metastatic renal cell carcinoma being the most common etiologies. The site of obstruction was localized to the central airways in 63 patients (40%) and the distal airways in 44 patients (28%), and it was diffuse in 49 patients (32%). Bronchoscopic airway patency was achieved in 95% of patients, with the highest success rates found in those with obstruction localized in the central airways. Improvement in symptoms occurred in 118 (82%) of 144 symptomatic patients. Serious complications were reported in 17 patients (11%) and included respiratory distress, severe bleeding, airway injury, and hemodynamic instability. All patients responded to treatment, and no intra- or postoperative deaths were reported.<bold>Conclusions: </bold>CD, when used alone or in combination with other endoscopic treatment modalities, appears to be safe and effective in treating endoluminal airway obstruction.
- Subjects
MASSACHUSETTS; LUNG cancer complications; BRONCHOSCOPY; COLD therapy; DEBRIDEMENT; LUNG cancer; LUNG tumors; RENAL cell carcinoma; RESPIRATORY obstructions; SURGICAL complications; RETROSPECTIVE studies; DISEASE complications
- Publication
Annals of the American Thoracic Society, 2016, Vol 13, Issue 6, p856
- ISSN
2329-6933
- Publication type
journal article
- DOI
10.1513/AnnalsATS.201508-486OC