Background: Lung carcinoid tumors are low grade cancerous tumours that develop from neuroendocrine cells that have become more common recently. Endobronchial bronchoscopic cryotherapy has gained interest by cardiothoracic surgeons as an alternative to the surgical bronchotomy. Objective: The aim of the current study is to assess the efficacy of bronchoscopic cryotherapy in the treatment of endobronchial typical carcinoid. Patients and methods: A prospective controlled clinical trial included 30 patients presented with endobronchial typical carcinoid from the January 2021 to the August 2022. Patients were randomly divided into two equal groups. Group A included patients who had excision of the endobrochial mass using bronchscopic cryotherapy, and Group B included patients who had excision of the endobrochial mass using open surgical bronchotomy. Follow up of the patients was performed on regular basis clinically, radiologically and by bronchoscopic evaluation. Results: The Hospitalization period was shorter in Group A (6±2 hours), than in Group B (8±3 hours) showing a statistically significant difference. There was a high statistically significant difference between both groups regarding the postoperative scar presence (0 % in Group A vesurs 100% in Group B). Intraoperative and peri-operative data showed a non-significant difference (p>0.05) between both studied groups. Conclusion: Bronchoscopic cryotherapy is an efficient and safe procedure for the excision of endobronchial typical carcinoid.

Background: Intrapleural fibrinolytics installation is considered an alternative method to aggressive operative intervention. This conservative medical management may decrease morbidity and mortality that were recorded with surgery. Our study investigates the outcome of tissue plasminogen activator (TPA), alteplase, and streptokinase (SK) as a treatment for stage II of empyema. Methods: This study prospectively evaluated 38 patients that had stage II of empyema. The patients were divided into two groups with installing one fibrinolytic protocol into a chest tube for each group: group A, (TPA) and group B, (SK). The evaluation was based upon clinical examination and radiological findings for the efficacy of each protocol. Results: There were no differences in baseline characteristics between both groups. There was a significant improvement after 1 st , where 11 patients (52.4%) improved in the TPA group with only 3 patients (17.6%) in the SK group. TPA group showed 100% success, on the other hand, SK Group had 2 patients' failure (11.8%) and surgical intervention was necessary for them. Hemorrhagic complications were 9.5% and 17.6% for TPA and SK respectively. Finally, there was a significantly prolonged duration of mean hospital stay with SK therapy (5.48 vs 8.59 days). Conclusions: Both fibrinolytic protocols were effective and safe for empyema management, but Alteplase had a better outcome.

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