Moorjani Narain, Beeson Julia E, Evans Joanna M, Maiwand M Omar
Department of Cryoresearch, Harefield Hospital, Middlesex, UB9 6JH, UK.
Interact Cardiovasc Thorac Surg. 2004 Dec;3(4):547-50. doi: 10.1016/j.icvts.2004.05.008.
Although cryosurgery has been shown to be effective in managing advanced malignant bronchial tumours, there is very little in the literature describing its use with benign lesions. In this study, we retrospectively assessed the effectiveness of cryosurgery in the management of non-malignant endobronchial lesions. Between 1995 and 1999, 20 patients with benign tumours and non-neoplastic lesions of the tracheo-bronchial tree were treated with endobronchial cryosurgery. The procedures were performed under general anaesthesia, using specifically designed cryoprobes. The patients were assessed clinically, radiologically and by respiratory function tests before and after each cryotreatment. Over the 5-year period, each patient received a mean 2.6 (range 1-9) cryo-applications, with no peri-operative deaths. All patients described a subjective improvement in at least one of their symptoms (cough, haemoptysis, stridor, chest pain or dyspnoea) following cryosurgery and 75% of patients improved in all symptoms. Following surgery, both forced expiratory volume in 1 s (2.23+/-0.27 vs. 1.98+/-0.25 l, P<0.05) and forced vital capacity (2.86+/-0.33 vs. 2.62+/-0.30 l, P<0.01) improved significantly. In conclusion, cryosurgery can provide effective symptomatic control in patients with non-malignant endobronchial lesions, the majority of whom are discharged on the day of surgery. It affords an easy to perform, safe procedure, which should be considered for patients with benign endobronchial lesions.
尽管冷冻手术已被证明在治疗晚期恶性支气管肿瘤方面有效，但文献中很少描述其在良性病变中的应用。在本研究中，我们回顾性评估了冷冻手术在治疗非恶性支气管内病变中的有效性。1995年至1999年间，20例气管支气管树良性肿瘤和非肿瘤性病变患者接受了支气管内冷冻手术治疗。手术在全身麻醉下进行，使用专门设计的冷冻探头。在每次冷冻治疗前后，对患者进行临床、放射学和呼吸功能测试评估。在这5年期间，每位患者平均接受2.6次（范围1 - 9次）冷冻治疗，无围手术期死亡。所有患者均表示冷冻手术后至少一种症状（咳嗽、咯血、喘鸣、胸痛或呼吸困难）有主观改善，75%的患者所有症状均有改善。手术后，第1秒用力呼气量（2.23±0.27 vs. 1.98±0.25升，P<0.05）和用力肺活量（2.86±0.33 vs. 2.62±0.30升，P<0.01）均显著改善。总之，冷冻手术可为非恶性支气管内病变患者提供有效的症状控制，其中大多数患者在手术当天即可出院。它提供了一种易于实施、安全的手术方法，对于支气管内良性病变患者应予以考虑。
