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甲状腺癌所致严重中央气道梗阻的支气管镜治疗:使用气管和倒Y形隆突自膨式金属支架联合气道支架置入术

Bronchoscopic management of critical central airway obstruction by thyroid cancer: Combination airway stenting using tracheal and inverted-Y carinal self-expanding metallic stents.

作者信息

Madan Karan, Shrestha Prajowl, Garg Rakesh, Hadda Vijay, Mohan Anant, Guleria Randeep

机构信息

Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India.

Department of Oncoanesthesia, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Lung India. 2017 Mar-Apr;34(2):202-205. doi: 10.4103/0970-2113.201297.

Abstract

Central airway obstruction (CAO) can result from various benign and malignant etiologies. Anaplastic thyroid cancer (ATC) is the most aggressive form of thyroid cancer. Rapid airway compromise is the main cause of death in ATC. We report a patient with ATC who presented with a large neck mass leading to CAO with long segment tracheal and right main bronchial compression and respiratory failure. Urgent Rigid Bronchoscopy was performed for airway stabilization and patient was managed with a combination airway stenting approach. A combination of self expanding, metallic, covered inverted Y and straight tracheal stents was used to stabilize the near complete airway structure. We herein highlight the role of therapeutic rigid bronchoscopy with airway stenting as an efficacious treatment modality for management of malignant CAO.

摘要

中央气道阻塞(CAO)可由多种良性和恶性病因引起。间变性甲状腺癌(ATC)是甲状腺癌中最具侵袭性的类型。气道迅速受压是ATC患者死亡的主要原因。我们报告1例ATC患者,其颈部有巨大肿块,导致CAO,伴有长段气管和右主支气管受压及呼吸衰竭。为稳定气道紧急实施了硬质支气管镜检查,并采用联合气道支架置入方法对患者进行治疗。使用自膨式金属覆膜倒Y形和直形气管支架组合来稳定几乎完全阻塞的气道结构。我们在此强调治疗性硬质支气管镜联合气道支架置入作为恶性CAO有效治疗方式的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a890/5351371/073cfa45865f/LI-34-202-g001.jpg

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