Endoscopic argon plasma coagulation for the management of solid, centrally located lung cancer

Abstract

Argon plasma coagulation (APC) is one of the interventional pulmonology techniques primarily aimed at the treatment of hemoptysis. It represents a form of non contact electrosurgey that uses ionized argon gas in order to produce electrical current that affects soft tissues. APC is reported to be effective in the treatment of early stage lung cancer, in the treatment of benign granulation tissue surrounding tracheal stents and in palliative treatment of malignant airway obstruction. Major indication for APC is hemostasis in severe hemoptysis, it can also be used as an alternative technique for laser resection or electrocautery, in urgent removal of tumors situated in large airways. The present article reports successful use of APC in the treatment of centrally located squamous cell lung cancer that caused complete right lung atelectasis. The use of APC led to complete reexpansion of the right lung and improvement in dyspnoea and chest discomfort of the patient. Significant improvement was observed in lung function parameters and blood gas analysis. With the use of APC solid tumor was completely removed from the right main bronchus and airway integrity was restored. From this case we can conclude that APC can be safely and successfully used for urgent debulking of malignant central airway obstruction

Argon-laser ablation is a new method of airways recanalization for tumoral stenosis

“…Эндопротезирование трахеи и крупных бронхов выполнимо далеко не всегда, тре-бует наличия недешевых стентов разного диаметра и длины [13,14]. Аргоноплазменная коагуляция сопровождается очень медленной деструкцией опухолевых масс и для реканализации при протяженных стенозах применима мало [8,9,15].…”

“…Авторами предложено проводить лазерное воздействие в среде газа, не поддерживающего горение, например аргона, а также разработано устройство для реализации метода. Путем ряда экспериментальных исследований выбраны наиболее удобные параметры лазерного воздействия, а также скорость подачи аргона [5,8,9]. В клинической практике эндоскопическое облучение опухолевой ткани проводили лазерным излучением с длиной волны 1060 нм, при этом в зону лазерного воздействия подавалась струя аргона с интенсивностью подачи 0,6-1,6 л/мин, а облучение стенозирующего образования проводили при плотности мощности 15-18 Вт/см 2 .…”

Therapeutic Bronchoscopy In Patients with Symptomatic Airway Lesions Argon Plasma Coagulation / Electrocautery

“…7,14,15,17,21,22,[34][35][36][37] Reichle et al reported that the APC complication ratio was 3.7%. 30 Shaw, et al and Reddy et al reported a case of cerebral gas embolisation that occurred during bronchoscopic APC.…”

Patient-related independent clinical risk factors for early complications following Nd: YAG laser resection of lung cancer

“…[5–11] All of the major interventional pulmonology guidelines are suggesting that Nd:YAG laser resection should be considered a part of multimodality treatment of advanced central lung cancer with endobronchial obstruction. [12–19] Nd:YAG laser resection alone or in combination with other interventional techniques demonstrated benefit in treatment of inoperable early stage lung cancer, in the treatment of benign CAO, and in multimodality treatment of central, advanced stage lung cancer. [20–27]…”