We previously reported satisfactory results with the Karakoca resector balloon in 10 patients with stage IV chronic obstructive pulmonary disease (COPD) who did not respond to medical treatment. In this article, we present the outcomes of the Karakoca resector balloon dilatation and curettage technique in a larger case series (n = 188).A total of 188 COPD patients [mean age (SD): 69.2 (8.0) years; 46 females] classified as stage III to IV by the Global Initiative for Obstructive Lung Disease criteria underwent balloon desobstruction for segmental and subsegmental bronchi by therapeutic bronchoscopy. None of the patients could have achieved symptom relief even under high-dose inhaled bronchodilators and corticosteroids, oral corticosteroids, or oxygen and noninvasive mechanical ventilation therapy before the intervention. Forced expiratory volume in 1 s (FEV1) and oxygen saturation (SpO2) were measured, and modified Borg dyspnea scale (MBS) scores were determined before and 1 week and 1 month after the intervention.All patients were active smokers and 80% had concomitant chronic diseases. After the intervention, there was a notable reduction in the oxygen need of the patients. Comparison of lung function tests 1 week after the procedure with results before the procedure showed significant improvements in FEV1, MBS, and SpO2 levels (P < 0.001 for each), and the improvements were maintained for the entire postprocedural month (P < 0.001 for each). Except for 4 males, all patients were free of symptoms.These results confirmed our early observations that balloon dilatation and curettage is a safe and successful technique for medical treatment-resistant COPD.
The anatomic extent of disease, that is described by the TNM-classification remains the most important prognostic factor for lung cancer. Based on the changes in tumor characteristics, advances in diagnostic methods and treatment strategies, TNM-classifications are updated from time to time. The 7th TNM-classification was created on the basis of an international, large, and retrospective database. However due to retrospective data, there are still unanswered questions. Therefore "Prospective Lung Cancer Staging Project" is designed. In this project, in addition to the detailed evaluation of T, N, M descriptors; other factors, which were not considered to be relevant to lung cancer staging before, were also analyzed such as demographic data, histologic characteristics, certain biochemical and molecular prognostic and predictive factors. This project will be the basis of 8th TNM-classification for lung cancer. In this manuscript, we discuss the probable changes from the 7th TNM classification to the 8th.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.