Guibert Nicolas, Mazieres Julien, Marquette Charles-Hugo, Rouviere Damien, Didier Alain, Hermant Christophe
Service de Pneumologie-Allergologie, Hôpital Larrey - CHU de Toulouse, Université de Toulouse III (Paul Sabatier), Toulouse, France
Service de Pneumologie-Allergologie, Hôpital Larrey - CHU de Toulouse, Université de Toulouse III (Paul Sabatier), Toulouse, France.
Eur Respir Rev. 2015 Sep;24(137):378-91. doi: 10.1183/16000617.00010014.
Tracheal or bronchial proximal stenoses occur as complications in 20-30% of lung cancers, resulting in a dramatic alteration in quality of life and poor prognosis. Bronchoscopic management of these obstructions is based on what are known as "thermal" techniques for intraluminal stenosis and/or placement of tracheal or bronchial prostheses for extrinsic compressions, leading to rapid symptom palliation in the vast majority of patients. This invasive treatment should only be used in cases of symptomatic obstructions and in the presence of viable bronchial tree and downstream parenchyma. This review aims to clarify 1) the available methods for assessing the characteristics of stenoses before treatment, 2) the various techniques available including their preferred indications, outcomes and complications, and 3) the integration of interventional bronchoscopy in the multidisciplinary management of proximal bronchial cancers and its synergistic effects with the other specific treatments (surgery, radiotherapy or chemotherapy).
气管或支气管近端狭窄是20%-30%肺癌的并发症，会导致生活质量急剧下降且预后不良。这些梗阻的支气管镜治疗基于腔内狭窄的“热”技术和/或用于外部压迫的气管或支气管假体置入，这能使绝大多数患者的症状迅速缓解。这种侵入性治疗仅应用于有症状的梗阻以及存在存活的支气管树和下游实质的情况。本综述旨在阐明：1）治疗前评估狭窄特征的可用方法；2）各种可用技术，包括其首选适应症、结果和并发症；3）介入性支气管镜检查在近端支气管癌多学科管理中的整合及其与其他特定治疗（手术、放疗或化疗）的协同作用。
