Bronchoscopic management of central airway obstruction

Stephens, Kenton E.; Wood, Douglas E.

doi:10.1016/s0022-5223(00)70184-x

Cited by 139 publications

(79 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The results reported by LOW et al [11] are considerable. Luminal diameters pre-and postprocedure were documented to increase on average by a factor of 2.6 in tracheal and 3.2 in bronchial lesions, comparing well with instant relief of dyspnoea reported previously for this method for other indications [12,13]. Two severely ill patients were even taken off mechanical ventilation immediately after the intervention and no complications of the procedures were reported.…”

supporting

confidence: 82%

A new tool for an old disease

Khanavkar¹

2004

Eur Respir J

View full text Add to dashboard Cite

supporting

confidence: 82%

A new tool for an old disease

Khanavkar¹

2004

Eur Respir J

View full text Add to dashboard Cite

“…In addition, the survival benefit of interventional bronchoscopy is difficult to demonstrate due to a lack of randomized trials (14). However, a variety of bronchoscopic techniques are now available for the management of malignant obstruction of the central airway (15)(16)(17). Therefore, the earlier application of interventional techniques in the management of these conditions, in combination with chemo-and radiotherapy, will likely have a greater impact on the quality of life and survival, especially in patients with activated EGFR mutations, compared with that observed with each individual treatment alone.…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment with a Combination of Electrocautery Using Wire Snares and Gefitinib in Patients with <i>EGFR</i>-mutant Lung Cancer and Central Airway Obstruction

et al. 2013

View full text Add to dashboard Cite

One-third of lung cancer patients present with life-threatening central airway obstruction (CAO). Two elderly patients were referred to our institution with symptoms caused by CAO. In each case, thoracic computed tomography and a bronchoscopic examination revealed a tumor obstructing the central airway. The tumors were resected endoscopically, and the patients' respiratory and performance status remarkably improved. Both patients were diagnosed with an advanced stage of lung adenocarcinoma harboring epidermal growth factor receptor (EGFR) mutations. They received gefitinib monotherapy, with partial responses sustained for more than 12 months. Combination therapy with endoscopic tumor resection and gefitinib is beneficial in patients with EGFR-mutant lung cancer and CAO.

show abstract

“…Symptoms develop when the CAO impairs airflow to the point of increasing the work of breathing or altering cardiopulmonary interactions [6, 7]. The air hunger experienced by patients is not related to hypoxia or hypercapnia, but to the increased effort required to obtain the normal velocity of air delivered to and from the lungs [6, 38]. Because of the dramatic decrease in airway diameter before the development of symptoms, up to 54% of patients with tracheal stenosis present in respiratory distress [6].…”

Section: Discussionmentioning

confidence: 99%

Vibration Response Imaging as a New Tool for Interventional-Bronchoscopy Outcome Assessment: A Prospective Pilot Study

Becker

Slawik²,

Miyazawa³

et al. 2008

Respiration

View full text Add to dashboard Cite

Background: In many patients, the benefit of interventional bronchoscopy cannot be appropriately objectified. Objectives: We investigated a new technique, vibration response imaging (VRI), for breathing sound mapping to determine whether it could provide additional, valuable objective qualitative and quantitative information in central airway obstruction (CAO) and patient outcome following interventional bronchoscopy. Methods: VRI images from 83 patients with suspected central airway stenosis and 25 healthy volunteers were evaluated by two raters blinded to the subjects’ status. Qualitative and quantitative dynamic and static features were documented for the final assessment of images as normal or abnormal and changes after the intervention. As a secondary goal, stenosis location was also evaluated and compared to bronchoscopic findings. Treatment outcome analysis (improved vs. not improved) was performed by comparing baseline and follow-up images in 64 evaluations of interventional bronchoscopy. VRI measurements of treatment outcome were compared to standard tests, i.e. dyspnea score, pulmonary function testing (PFT, i.e. FEV₁, FVC and FEV₁/FVC), chest X-ray/computed tomography and bronchoscopy, the latter being considered the gold standard). Results: There was 95% (115/121) agreement between raters and clinical assessment in distinguishing between normal and abnormal images. The sensitivity and specificity of VRI were 97 and 88%, respectively. The accuracy of VRI in locating the pathology compared to bronchoscopy was 85% (17/20) for tracheal and 88% (51/58) for bronchial obstruction; overall accuracy was 83%. Correct detection of the affected side in bronchial obstructions was 88%. The overall accuracy of VRI in defining the outcome of interventional bronchoscopy was 84%. Conclusions: Obstruction location and procedure outcome were reliably identified according to specific patterns of lung images. VRI proved at least as good as standard tests in locating CAO and has the potential for becoming a valuable complementary tool in evaluating treatment outcome in patients with CAO. If our results are confirmed by further studies, VRI may replace PFT or imaging procedures in cases in which such tests cannot be performed or are not readily available at the time of the intervention.

show abstract

Bronchoscopic management of central airway obstruction

Abstract: Endobronchial surgical techniques can be used safely and systematically for the relief of benign and malignant central airway obstructions; a diversity of approaches and interventions are required to produce and maintain palliation of airway symptoms.

Cited by 139 publications

References 22 publications

A new tool for an old disease

A new tool for an old disease

Successful Treatment with a Combination of Electrocautery Using Wire Snares and Gefitinib in Patients with <i>EGFR</i>-mutant Lung Cancer and Central Airway Obstruction

Vibration Response Imaging as a New Tool for Interventional-Bronchoscopy Outcome Assessment: A Prospective Pilot Study

Contact Info

Product

Resources

About