Uğur Chousein Efsun Gonca, Turan Demet, Özgül Mehmet Akif, Çetinkaya Erdoğan
Department of Chest Diseases, Health Sciences University, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2021 Jul 26;29(3):360-369. doi: 10.5606/tgkdc.dergisi.2021.19927. eCollection 2021 Jul.
In this study, we aimed to share our singlecenter experience and to investigate the effect of interventional bronchoscopic procedures on secondary pulmonary malignancies in terms of complications, success, and survival rates.
A total of 83 patients (42 males, 41 females; mean age: 57.8±15.2 years; range, 18 to 94 years) with secondary pulmonary malignancies who underwent interventional bronchoscopic procedures between January 2009 and December 2019 were retrospectively reviewed. Data including demographic and clinical characteristics of the patients, complications, and success and survival rates were recorded.
The most common secondary pulmonary malignancies were kidney and thyroid tumors with the complaints of cough, shortness of breath, and hemoptysis. The mean duration before the diagnosis was 34.7±52.8 (range, 0.1 to 219.3) months, and the mean survival after the diagnosis were 10±13.1 (range, 0.2 to 44.4) months. A total of 92% of the patients had an airway obstruction of >50% and the interventional bronchoscopic procedures such as argon plasma coagulation, laser, cryo, and mechanical resection were successful in achieving airway patency. Laser application was found to significantly improve survival (p=0.015). Acute complication rate was 8.4% and mortality rate was 0%.
In patients with tracheobronchial lesions due to secondary pulmonary malignancies, interventional bronchoscopic procedures, regardless of the stage of the disease, provide rapid palliation in life-threatening symptoms such as dyspnea and hemoptysis due to airway obstruction, prolonging patient"s survival and gain time for additional treatments to take effect for primary disease.
在本研究中,我们旨在分享我们的单中心经验,并从并发症、成功率和生存率方面研究介入性支气管镜检查对继发性肺恶性肿瘤的影响。
回顾性分析2009年1月至2019年12月期间接受介入性支气管镜检查的83例继发性肺恶性肿瘤患者(42例男性,41例女性;平均年龄:57.8±15.2岁;范围18至94岁)。记录包括患者的人口统计学和临床特征、并发症以及成功率和生存率等数据。
最常见的继发性肺恶性肿瘤是肾和甲状腺肿瘤,伴有咳嗽、气短和咯血症状。诊断前的平均持续时间为34.7±52.8(范围0.1至219.3)个月,诊断后的平均生存期为10±13.1(范围0.2至44.4)个月。共有92%的患者气道阻塞>50%,氩等离子体凝固、激光、冷冻和机械切除等介入性支气管镜检查成功实现了气道通畅。发现激光应用可显著提高生存率(p=0.015)。急性并发症发生率为8.4%,死亡率为0%。
对于因继发性肺恶性肿瘤导致气管支气管病变的患者,无论疾病处于何阶段,介入性支气管镜检查均可迅速缓解因气道阻塞引起的呼吸困难和咯血等危及生命的症状,延长患者生存期,并为原发性疾病的其他治疗生效争取时间。