Hetzel Martin, Hetzel Juergen, Schumann Christian, Marx Nikolaus, Babiak Alexander
Department of Internal Medicine II-Pulmonary Medicine, University Medical Center Ulm, Ulm, Germany.
J Thorac Cardiovasc Surg. 2004 May;127(5):1427-31. doi: 10.1016/j.jtcvs.2003.12.032.
Endobronchial cryotherapy is an established recanalization method for stenoses of the respiratory tract. However, previous applications of cryotherapy have not been immediately effective, requiring a second clean-up procedure several days later to finally obtain sufficient recanalization. In this study we demonstrate a newly developed cryoprobe allowing recanalization of tumor stenoses during a single intervention.
In this prospective study flexible bronchoscopy was used for cryorecanalization of 60 patients with high-grade stenoses of the respiratory tract from exophytic tumors. Tumor tissue was frozen on the tip of the probe and subsequently removed from the surrounding respiratory tract tissue through retraction of the probe. Procedures were carried out on sedated, spontaneously breathing, intubated patients.
Fifty (83%) of 60 patients were successfully or partially successfully treated. Tumor bleeding occurred in 6 patients but was stopped with argon plasma coagulator treatment in all patients not requiring rigid bronchoscopy.
Cryorecanalization with the newly developed cryoprobe permits effective, safe, and inexpensive therapy of endobronchial stenoses of the respiratory tract.
支气管内冷冻疗法是一种治疗呼吸道狭窄的成熟再通方法。然而，以往的冷冻疗法应用并非立即有效，需要在数天后进行二次清理程序才能最终获得足够的再通效果。在本研究中，我们展示了一种新开发的冷冻探头，可在单次干预中实现肿瘤性狭窄的再通。
在这项前瞻性研究中，使用柔性支气管镜对60例因外生性肿瘤导致呼吸道高度狭窄的患者进行冷冻再通治疗。肿瘤组织在探头尖端被冷冻，随后通过回撤探头从周围呼吸道组织中移除。手术在镇静、自主呼吸、插管的患者身上进行。
60例患者中有50例（83%）获得成功或部分成功治疗。6例患者出现肿瘤出血，但所有无需硬质支气管镜检查的患者均通过氩等离子体凝固器治疗止血。
使用新开发的冷冻探头进行冷冻再通可有效、安全且廉价地治疗呼吸道支气管内狭窄。
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