Prognostic factors for bronchoscopic intervention in advanced lung or esophageal cancer patients with malignant airway obstruction

Song, Jae-Uk; Park, Hye Yun; Kim, Hojoong; Jeon, Kyeongman; Um, Sang‐Won; Koh, Won‐Jung; Suh, Gee Young; Chung, Man Pyo; Kwon, O Jung

doi:10.4103/1817-1737.109818

Cited by 12 publications

(2 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The time required for stent placement is short, the cost is high, and restenosis can easily occur. Therefore, repeated endoscopic probe dilatation is still the most preferred treatment for esophageal stenosis[ 11 ]. Dilation for esophageal stenosis relies on the mechanical destruction of scar tissue by the dilation probe to dilate the stenosis.…”

Section: Introductionmentioning

confidence: 99%

Follow-up study on symptom distress in esophageal cancer patients undergoing repeated dilation

Liu

et al. 2020

WJCC

View full text Add to dashboard Cite

BACKGROUND Repeated endoscopic probe dilatation is the most preferred treatment for esophageal stenosis which may cause high levels of symptom distress in the patient's home rehabilitation stage. AIM To explore the changes in the symptom distress level and its correlation with the dilation effect in patients with esophageal carcinoma undergoing repeated dilations for lumen stenosis. METHODS The difference (R2-R1) between the diameter of the esophageal stenosis opening (R1) of the patients before dilation (R1) and after dilation (R2) was calculated to describe the extent and expansion of the esophageal stenosis before and after dilation. The M.D. Anderson Symptom Inventory was used to describe the symptom distress level of patients with dilation intermittence during their stay at home and to explore the correlation between the dilation effect and symptom distress level. RESULTS The diameter of the esophagus (R1) increased before each dilation in patients undergoing esophageal dilation ( P < 0.05). The diameter (R2) increased after dilation ( P < 0.05); the dilation effect (R2-R1) decreased with the number of dilations ( P < 0.05). The total symptom distress score significantly increased with the number of dilations ( P < 0.05). The symptom distress scores of the patients were negatively correlated ( P < 0.05) with the previous dilation effect (R2-R1) and the esophageal diameter (R2) after the previous dilation. After the 1 st to 4 th dilations, the patient's symptom distress score was negatively correlated with the esophageal diameter (R12) before the next dilation, while there was no significant correlation ( P > 0.05) with the other dilations. CONCLUSION In patients who have undergone repeated dilations, better effect stands for lower symptom distress level and the increase in symptom distress has a prompt effect on the severity of the next occurrence of restenosis.

show abstract

Section: Introductionmentioning

confidence: 99%

Follow-up study on symptom distress in esophageal cancer patients undergoing repeated dilation

Liu

et al. 2020

WJCC

View full text Add to dashboard Cite

show abstract

“…MAO will most probably occur more frequently in the future because of increasing cancer incidence and increased life expectancy. Patients with MAO are often suffering from mild to severe dyspnoea, cough, recurrent pneumonia and frequent hospitalisation, and the prognosis varies considerably ( 5 ). These secondary symptoms can also become life-threatening.…”

mentioning

confidence: 99%

A new removable airway stent

Amundsen

Sørhaug

Leira

et al. 2016

European Clinical Respiratory Journal

View full text Add to dashboard Cite

BackgroundMalignant airway obstruction is a feared complication and will most probably occur more frequently in the future because of increasing cancer incidence and increased life expectancy in cancer patients. Minimal invasive treatment using airway stents represents a meaningful and life-saving palliation. We present a new removable airway stent for improved individualised treatment.MethodsTo our knowledge, the new airway stent is the world's first knitted and uncovered self-expanding metal stent, which can unravel and be completely removed. In an in vivo model using two anaesthetised and spontaneously breathing pigs, we deployed and subsequently removed the stents by unravelling the device. The procedures were executed by flexible bronchoscopy in an acute and a chronic setting – a ‘proof-of-principle’ study.ResultsThe new stent was easily and accurately deployed in the central airways, and it remained fixed in its original position. It was easy to unravel and completely remove from the airways without clinically significant complications. During the presence of the stent in the chronic study, granulation tissue was induced. This tissue disappeared spontaneously with the removal.ConclusionsThe new removable stent functioned according to its purpose and unravelled easily, and it was completely removed without significant technical or medical complications. Induced granulation tissue disappeared spontaneously. Further studies on animals and humans are needed to define its optimal indications and future use.

show abstract

Outcome differences between recanalized malignant central airway obstruction from endoluminal disease versus extrinsic compression

et al. 2018

View full text Add to dashboard Cite

We compared the outcome of Nd:YAG laser therapy with stent placement for malignant central airway obstruction (CAO) at our center over a 10-year period. This is a retrospective review of patients undergoing Nd:YAG laser therapy or self-expanding metal stent (SEMS) placement for malignant CAO between November 2007 and October 2017. Seventy-two patients were recanalized for malignant CAO. The median (range) age was 63 (23-86) years, with 49 (68%) males. Patients underwent either laser therapy alone (N = 36), stent placement alone (N = 30), or both (N = 6). The wavelength of Nd:YAG laser used was 1064 nm, and median (range) laser energy used was 25 (15-35) W, in 377 (115-1107) pulses. Fifty-one (71%) patients died with median survival of 7.2 months. In subgroup analysis, 21 (58.3%) vs. 25 (83.3%), p = 0.03 patients died in the Blaser resection^vs. Bstent placementĝ roup with longer median survival of 12.4 months in the former vs. 4.5 months, p = 0.0004 in the later. Esophageal cancer and left main bronchus involvement were significantly more common (10 (33.3%) vs. 0, p = 0.0001, and 16 (53.3%) vs. 8 (22.2%), p = 0.01), in the stent placement vs. laser resection group, respectively. Trachea or main bronchi involvement and respiratory failure on presentation requiring mechanical ventilation correlated with poorer survival. The immediate restoration of luminal patency, complication rate, and 30-day mortality was similar among the two groups. The median (range) energy used for laser therapy was 25 (15-35) W. Median of 377 pulses was used for the duration of 287.5 s. The results were compared using a Wilcoxon two-sample test, and Fischer exact test with p values considered indicative of a significant difference if less than 0.05. In patients requiring recanalization of malignant CAO, the extrinsic compression from esophageal cancer, trachea or main bronchi involvement, respiratory failure on presentation requiring mechanical ventilation, and stent placement correlated with poorer survival. Interventional pulmonology training program should emphasize on dedicated training in laser therapy as it is associated with improved survival.

show abstract

Prognostic factors for bronchoscopic intervention in advanced lung or esophageal cancer patients with malignant airway obstruction

Cited by 12 publications

References 20 publications

Follow-up study on symptom distress in esophageal cancer patients undergoing repeated dilation

Follow-up study on symptom distress in esophageal cancer patients undergoing repeated dilation

A new removable airway stent

Outcome differences between recanalized malignant central airway obstruction from endoluminal disease versus extrinsic compression

Contact Info

Product

Resources

About