Chen Chia-Hung, Wu Biing-Ru, Cheng Wen-Chien, Chen Chih-Yu, Chen Wei-Chun, Hsia Te-Chun, Liao Wei-Chih, Tu Chih-Yen, Hsu Wu-Huei
aDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital bDepartment of Respiratory Therapy cGraduate Institute of Clinical Medical Science dDepartment of Internal Medicine, Hyperbaric Oxygen Therapy Center eSchool of Medicine fDepartment of Life Science, National Chung Hsing University, Taichung, Taiwan.
Medicine (Baltimore). 2017 Jan;96(2):e5612. doi: 10.1097/MD.0000000000005612.
Patients with central airway obstruction (CAO) may need endobronchial intervention to relieve their symptoms. This report is on a single-center experience of using interventional bronchoscopy in terms of complications and survival. This retrospective study was conducted in a university hospital and involved 614 patients (464 men, 150 women; mean age, 60.2 years) with benign (n = 133) and malignant (n = 481) tracheobronchial disease who received 756 endobronchial intervention procedure during the period 2008 to 2015. Survival was analyzed using the Kaplan-Meier method, while the log-rank test was used for comparisons. A total of 583 patients (95%) achieved endoscopic success after interventional bronchoscopy. Four (0.7%) died within 24 hours of the procedure, while the major morbidities were halitosis (n = 41, 6.7%) and iatrogenic pneumonia (n = 24, 3.9%). Repeat procedures due to recurrent airway obstruction were done on 45 patients with benign conditions and on 60 with malignancies. The median survival after the procedure in patients with lung cancer, other metastatic cancer, and esophageal cancer was 166, 228, and 86 days, respectively. Between patients with inoperable lung cancer and CAO after therapeutic bronchoscopy and patients without CAO, there was no statistically significant difference in survival (P = 0.101). Interventional bronchoscopy is a safe and effective procedure that may be recommended for CAO. Patients with lung metastases have similar lengths of survival as patients with primary lung cancer. Patients with advanced lung cancer and CAO have similar survival as those without CAO.
中央气道梗阻(CAO)患者可能需要进行支气管内介入治疗以缓解症状。本报告是关于在并发症和生存率方面使用介入性支气管镜检查的单中心经验。这项回顾性研究在一家大学医院进行,纳入了614例患者(464例男性,150例女性;平均年龄60.2岁),这些患者患有良性(n = 133)和恶性(n = 481)气管支气管疾病,在2008年至2015年期间接受了756次支气管内介入治疗。使用Kaplan-Meier方法分析生存率,同时使用对数秩检验进行比较。共有583例患者(95%)在介入性支气管镜检查后获得内镜成功。4例(0.7%)在手术后24小时内死亡,主要并发症为口臭(n = 41,6.7%)和医源性肺炎(n = 24,3.9%)。45例良性疾病患者和60例恶性肿瘤患者因复发性气道梗阻进行了重复手术。肺癌、其他转移性癌症和食管癌患者术后的中位生存期分别为166天、228天和86天。治疗性支气管镜检查后患有不可切除肺癌和CAO的患者与无CAO的患者之间,生存率无统计学显著差异(P = 0.101)。介入性支气管镜检查是一种安全有效的治疗方法,可推荐用于CAO。肺转移患者的生存期与原发性肺癌患者相似。晚期肺癌和CAO患者的生存率与无CAO患者相似。