Zarić B, Canak V, Sarcev T, Marković M, Jovanović S, Budisin E
Institute for Pulmonary Diseases of Vojvodina, Clinic for Pulmonary Oncology, Department of Interventional Pulmonology, Medical Faculty, University of Novi Sad, Serbia.
J BUON. 2007 Jan-Mar;12(1):11-22.
In recent years interventional pulmonology techniques have found their place in the palliative treatment of lung cancer invading central airways (trachea and principal bronchi). The curative effect of interventional techniques is reported in a number of studies with very different success ratios, but with excellent potential and perspective. Increase in number and variety of these techniques led to the development of internationally accepted guidelines for their use. The choice of a specific interventional technique in the treatment of lung cancer patients with central airway obstruction (CAO) depends on several factors: patient's general condition and comorbidities, type and characteristics of airway stenosis, availability of techniques and trained personnel. The aim of this review was to introduce interventional pulmonology procedures aimed at urgent desobstruction of central airways obstruction to medical oncologists who are dealing with the problem of malignant CAO. We tried to emphasize indications, contraindications, technique procedure and possible complications in the treatment of malignant CAO. At the Institute for Pulmonary Diseases of Vojvodina Nd: YAG laser resection, electrocautery, argon plasma coagulation and metallic and silicone stent insertions for immediate treatment of malignant CAO are practised.
近年来,介入肺脏病学技术在侵犯中央气道(气管和主支气管)的肺癌姑息治疗中占据了一席之地。多项研究报道了介入技术的治疗效果,成功率差异很大,但具有巨大的潜力和前景。这些技术的数量和种类不断增加,促使国际上制定了相关的应用指南。在治疗伴有中央气道阻塞(CAO)的肺癌患者时,选择特定的介入技术取决于多个因素:患者的一般状况和合并症、气道狭窄的类型和特征、技术的可及性以及专业人员的配备。这篇综述的目的是向处理恶性CAO问题的肿瘤内科医生介绍旨在紧急解除中央气道阻塞的介入肺脏病学操作。我们试图强调在治疗恶性CAO时的适应证、禁忌证、技术操作及可能出现的并发症。在伏伊伏丁那肺病研究所,采用钕钇铝石榴石(Nd: YAG)激光切除术、电灼术、氩等离子体凝固术以及金属和硅酮支架置入术来即刻治疗恶性CAO。