Aktaş Zafer, Yılmaz Aydın, Öztürk Ayperi, Karataş Mevlüt
Clinic of Interventional Pulmonology, Ankara Ataturk Chest Diseases and Chest Surgery Training and Research Hospital, Ankara, Turkey.
Tuberk Toraks. 2018 Dec;66(4):312-316. doi: 10.5578/tt.67434.
Recently, treatment of endobronchial hamartomas with interventional bronchoscopic methods has become possible. Although there are several reports of therapeutic benefits, the protocol of administration varies between centers and high recurrence rates continue to be a problem. In this study, we aimed to show that cryotherapy applied to the root of the bronchial wall after removal of the intraluminal portion of endobronchial hamartoma with interventional bronchoscopic methods can prevent recurrences.
Between 2012-2016, the treatment outcomes and long-term follow-up data of patients with symptomatic endobronchial hamartomas treated by interventional bronchoscopic methods were prospectively recorded. After debulking, cryotherapy was applied to the root of the bronchial wall of all lesions. The data were analyzed retrospectively.
A total of 21 consecutive patients were studied. Twenty (95.2%) of the patients underwent complete resection and only 1 (4.8%) had incomplete resection with various interventional bronchoscopy techniques. One (4.8%) patient who underwent incomplete resection and ineffective cryotherapy relapsed. The other 20 (95.2%) patients were followed up periodically for an average of 36.0 ± 15.0 months. No recurrence was detected. No complications or deaths related to the procedure were observed.
Debulking of endobronchial hamartomas with interventional bronchoscopic methods is effective and safe. Cryotherapy to the root of the lesion may prevent high recurrence rates.
最近,采用介入性支气管镜方法治疗支气管内错构瘤已成为可能。尽管有几篇关于治疗益处的报道,但各中心的给药方案各不相同,高复发率仍是一个问题。在本研究中,我们旨在表明,采用介入性支气管镜方法切除支气管内错构瘤腔内部分后,对支气管壁根部进行冷冻治疗可预防复发。
前瞻性记录2012年至2016年间采用介入性支气管镜方法治疗的有症状支气管内错构瘤患者的治疗结果和长期随访数据。在减瘤后,对所有病变的支气管壁根部进行冷冻治疗。对数据进行回顾性分析。
共研究了21例连续患者。20例(95.2%)患者通过各种介入性支气管镜技术实现了完全切除,只有1例(4.8%)切除不完全。1例(4.8%)切除不完全且冷冻治疗无效的患者复发。其他20例(95.2%)患者平均随访36.0±15.0个月,未发现复发。未观察到与该手术相关的并发症或死亡。
采用介入性支气管镜方法对支气管内错构瘤进行减瘤是有效且安全的。对病变根部进行冷冻治疗可能预防高复发率。