Jung Bockhyun, Murgu Septimiu, Colt Henri
Department of Internal Medicine, Pulmonary and Critical Care Medicine, University of Ulsan, Gangneung Asan Hospital, Gangneung, Korea.
Ann Thorac Cardiovasc Surg. 2011;17(1):53-7. doi: 10.5761/atcs.cr.09.01480.
Central airway obstruction (CAO) and superior vena cava (SVC) syndrome are potentially life-threatening complications in locally advanced lung cancer. Therapeutic rigid bronchoscopy has become an critical component in the treatment of the lung cancer patients with CAO who are not surgical candidates. However, the technique may pose significant risks in patients with coexisting SVC syndrome, especially, and even more so perhaps in patients over the age of eighty. In this case report, we address the potential risks and known benefits of therapeutic bronchoscopic intervention in an 85-year-old man with small cell lung cancer who presented with acute dyspnea secondary to advanced SVC syndrome and CAO involving the lower trachea and right main bronchus. Emergent therapeutic rigid bronchoscopy resulted in a marked improvement, in dyspnea, atelectasis, and postobstructive pneumonia, allowing rapid administration of systemic chemotherapy.
中央气道阻塞（CAO）和上腔静脉（SVC）综合征是局部晚期肺癌中潜在的危及生命的并发症。治疗性硬质支气管镜检查已成为无法进行手术的CAO肺癌患者治疗的关键组成部分。然而，该技术在合并SVC综合征的患者中可能带来重大风险，尤其是在80岁以上的患者中可能风险更高。在本病例报告中，我们探讨了对一名85岁小细胞肺癌男性患者进行治疗性支气管镜干预的潜在风险和已知益处，该患者因晚期SVC综合征和累及下气管及右主支气管的CAO而出现急性呼吸困难。紧急治疗性硬质支气管镜检查使呼吸困难、肺不张和阻塞性肺炎得到显著改善，从而能够迅速进行全身化疗。
