Outcomes of airway stenting for advanced lung cancer with central airway obstruction

Saji, Hisashi; Furukawa, Kinya; Tsutsui, Hidemitsu; Tsuboi, Masahiro; Ichinose, Shuji; Usuda, Jitsuo; Ohira, Tetsuya; Ikeda, Norihiko

doi:10.1510/icvts.2010.238196

Cited by 94 publications

(88 citation statements)

References 12 publications

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“…It provides a bridge for airway patency in patients undergoing systemic chemotherapy or radiation. Although the overall survival was not changed, the median survival time could be increased after airway stenting if it was combined with adjuvant therapy (47).…”

Section: Stentmentioning

confidence: 96%

Central airway tumors: interventional bronchoscopy in diagnosis and management

Lin

Chung

2016

J. Thorac. Dis.

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The diagnosis of central airway tumors is usually challenging because of the vague presentations.Advances in visualization technology in bronchoscopy aid early detection of bronchial lesion. Cryotechnology has great impact on endobronchial lesion sampling and provides better diagnostic yield. Airway tumor involvements result in significant alteration in life quality and lead to poor life expectancy. Timely and efficiently use ablation techniques by heat or cold energy provide symptoms relief for central airway obstruction. Prostheses implantation is effective in maintaining airway patency after ablative procedure or external compression. Combined interventional bronchoscopy modalities and other adjunctive therapies have improvement in quality of life and further benefit in survival. This review aims to provide a diagnostic approach to central airway tumors and an overview of currently available techniques of interventional bronchoscopy in managing symptomatic central airway obstruction. Here, we provide a clinical review of interventional bronchoscopy in diagnoses and management of central airway tumors. Keywords Diagnostic modalities Computed tomographyOnly less than 30% patients with tracheal tumors have been diagnosed via chest radiography (14). Traditional CT scan is more sensitive and can provide information on the extent of airway lesions. Newly developed multidetector CT (MDCT) can accurately detect airway tumor locations, natures, quantities (1). The extra luminal anatomy is also clearly depicted. Thus, MDCT is a rapid and non-invasive method to provide comprehensive information about the extent of disease process before surgery or interventional bronchoscopy (1). Visualization of bronchoscopyBronchoscopy is the mainstay to approaching endobronchial lesion under direct vision. In addition to conventionally white light bronchoscopy, autofluorescence (AFB) and narrow band imaging (NBI) are new visualization techniques of bronchoscopy which can aid detection of bronchial mucosa lesions (15). Although the specificity of AFB is low and similar to white light bronchoscopy, there is no doubt in usefulness of detecting early bronchial mucosal lesion and evaluate the margin of mucosal involvement (16,17). NBI is designed to detect angiogenesis and neovascular lesion. The diagnostic accuracy is increased under NBI bronchoscopy (15). Both of them have superior sensitivity comparing with white light bronchoscopy [3][4][5]. Endobronchial ultrasonography (EBUS) is also helpful in evaluating the extent of airway lesion involvement (14,18). Tissue sampling: forceps versus cryotechnologyForceps biopsy under direct bronchoscopic vision is the most common method to obtain tissue sample from endobronchial lesion. However, the size of tissue sample is limited by the forceps size. Small samples with crush artifacts are probably insufficient for accurate diagnosis. The diagnostic yield is only 85% of conventional forceps biopsy and patients usually have to repeat bronchoscopy (2,3).Cryotechnology has been used as a t...

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Section: Stentmentioning

confidence: 96%

Central airway tumors: interventional bronchoscopy in diagnosis and management

Lin

Chung

2016

J. Thorac. Dis.

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“…[13][14][15][16][17][18] Reported complication rates are low, but complications and outcomes diff er signifi cantly depending on the indication for the procedure (ie, malignant vs benign disease, isolated hemoptysis vs central airway obstruction), and in most studies, signifi cant heterogeneity existed in terms of patient population and indications. 1,4 Many of these studies focused on individual technologies, such as stents, microdebriders, or APC, and most were performed at centers of excellence as part of ongoing research programs.…”

mentioning

confidence: 99%

Complications Following Therapeutic Bronchoscopy for Malignant Central Airway Obstruction

Ost

Ernst

Grosu

et al. 2015

Chest

147

103

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“…7) One patient (Case 10) who survived for a long period of time, had a tracheal adenoid cystic carcinoma. Because all patients except one had aggressive and advanced carcinoma, the post-treatment prognosis was very poor.…”

Section: Discussionmentioning

confidence: 99%