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支气管镜下姑息治疗气管支气管树的支气管内转移。

Bronchoscopic palliation to treat endobronchial metastasis of the tracheobronchial tree.

作者信息

Dalar Levent, Özdemir Cengiz, Sökücü Sinem Nedime, Karasulu Levent, Altın Sedat

机构信息

Istanbul Bilim University, School of Medicine, Department of Pulmonary Medicine, Sisli Florence Nightingale Hospital, Abidei Hurriyet cd. 166, Sisli, Istanbul, Turkey.

Yedikule Teaching Hospital for Pulmonology and Thoracic Surgery, Istasyon Yolu cad, Zeytinburnu, Istanbul, Turkey.

出版信息

Respir Investig. 2016 Mar;54(2):116-20. doi: 10.1016/j.resinv.2015.09.001. Epub 2015 Nov 20.

Abstract

BACKGROUND

Endobronchial metastases (EBM) are rarely observed, but they are caused by a number of different tumors. Bronchoscopy is the main approach for both differential diagnosis and to maintain endoluminal palliation. In this study, consecutive EBM cases that had been diagnosed and treated were evaluated in a retrospective cohort.

METHODS

In total, 18 pathologically verified patients with EBM originating from extrathoracic tumors who were referred to our interventional pulmonology unit with respiratory symptoms were retrospectively evaluated. Tumor type, metastasis location, treatment method and frequency, and complications were evaluated.

RESULTS

In total, there were 18 patients (13 women) with EBM enrolled in this study. All were diagnosed by a bronchial biopsy. The mean age of the patients was 48±15.24 years (range: 24-76 years). The most frequent sites of origin of the metastases were the bone (5) and kidney. Obstructions were observed in the tracheas of 12 patients, in the right main bronchi of 10, and in the left main bronchi of 11. Twelve airway stents were placed in nine patients. The removal of the obstruction was effective in the remaining patients. The mean number of treatment applications was 1.47 (range: 1-3). Hemorrhage, mucostasis, and granulation were observed. The median follow-up duration was 528 days (range: 62-1177 days). The median survival time for the patients who died was 122 days (range: 2-885 days).

CONCLUSIONS

EBM is rare, and bronchoscopy is the primary method of diagnosis, followed by palliation, if necessary.

摘要

背景

支气管内转移(EBM)很少见,但可由多种不同肿瘤引起。支气管镜检查是鉴别诊断和维持腔内姑息治疗的主要方法。在本研究中,对一系列已确诊并接受治疗的EBM病例进行了回顾性队列评估。

方法

对总共18例经病理证实的源自胸外肿瘤的EBM患者进行回顾性评估,这些患者因呼吸道症状转诊至我们的介入肺科。评估肿瘤类型、转移部位、治疗方法及频率和并发症。

结果

本研究共纳入18例EBM患者(13例女性)。均通过支气管活检确诊。患者的平均年龄为48±15.24岁(范围:24 - 76岁)。转移最常见的起源部位是骨骼(5例)和肾脏。12例患者的气管、10例患者的右主支气管和11例患者的左主支气管出现阻塞。9例患者置入了12个气道支架。其余患者的阻塞解除有效。治疗应用的平均次数为1.47次(范围:1 - 3次)。观察到出血、黏液潴留和肉芽形成。中位随访时间为528天(范围:62 - 1177天)。死亡患者的中位生存时间为122天(范围:2 - 885天)。

结论

EBM罕见,支气管镜检查是主要的诊断方法,必要时可进行姑息治疗。

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