Benn Bryan S, Lum Mendy, Krishna Ganesh
Department of Medicine, Division of Pulmonary and Critical Care, University of California, Irvine.
Respiratory Care Services, El Camino Hospital, Mountain View.
J Bronchology Interv Pulmonol. 2021 Jan 1;28(1):34-41. doi: 10.1097/LBR.0000000000000675.
Airway obstructions (AOs) in the central airway or lobar bronchi develop due to malignant or benign disease. Because of the morbidity and mortality associated with AO, it is important to develop additional therapeutic ablative techniques. CoreCath2.7S is a novel monopolar radiofrequency electrosurgical device approved to treat obstructions of the upper airway and tracheobronchial tree by both cutting soft tissue and providing electrosurgical hemostasis. We present a large case series describing its use.
Retrospective chart review was performed of all patients with AO undergoing airway recanalization with CoreCath2.7S at 2 interventional pulmonology practices from October 2017 to May 2019. Demographic information, AO etiology, location, and degree, and therapeutic modalities used were recorded.
Fifty-three patients underwent 64 procedures for AO due to malignant (n=30, 57%) or benign (n=23, 43%) disease. AOs were treated in the trachea (n=28), mainstem bronchi (n=23), and lobar bronchi (n=17). All AO occluded the airway at least 50%. Adjunctive therapeutic modalities were commonly used (n=60, 94%), including flexible cryoprobe (n=33), balloon dilation (n=23), rigid bronchoscopy (n=19), spray cryotherapy (n=19), argon plasma coagulation (n=14), and stenting (n=5). Restoration of airway patency was achieved in all cases without any periprocedural or immediate postprocedural complications.
CoreCath2.7S was successfully used to treat patients with AO due to malignant or benign disease. Airway patency was restored with no periprocedural or immediate postprocedural complications. It should be considered as another therapeutic modality in the growing field of ablative techniques for the treatment of AO.
中央气道或叶支气管的气道阻塞（AO）可由恶性或良性疾病引起。鉴于与AO相关的发病率和死亡率，开发额外的治疗性消融技术很重要。CoreCath2.7S是一种新型单极射频电外科设备，已获批通过切割软组织和提供电外科止血来治疗上气道和气管支气管树的阻塞。我们展示了一个描述其使用情况的大型病例系列。
对2017年10月至2019年5月在2家介入肺病科诊所接受CoreCath2.7S气道再通治疗的所有AO患者进行回顾性病历审查。记录人口统计学信息、AO的病因、位置、程度以及所使用的治疗方式。
53例患者因恶性（n = 30，57%）或良性（n = 23，43%）疾病接受了64次AO治疗手术。AO发生在气管（n = 28）、主支气管（n = 23）和叶支气管（n = 17）。所有AO至少阻塞气道50%。辅助治疗方式常用（n = 60，94%），包括可弯曲冷冻探头（n = 33）、球囊扩张（n = 23）、硬质支气管镜检查（n = 19）、喷雾冷冻疗法（n = 19）、氩等离子体凝固（n = 14）和支架置入（n = 5）。所有病例均实现了气道通畅，且无任何围手术期或术后即刻并发症。
CoreCath2.7S成功用于治疗因恶性或良性疾病导致AO的患者。恢复了气道通畅，且无围手术期或术后即刻并发症。在不断发展的AO消融技术治疗领域，应将其视为另一种治疗方式。
