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支气管镜激光和硅胶Y形支架在继发性甲状腺癌所致中央气道狭窄紧急气道管理中的应用:一例报告

Bronchoscopy Laser and Silicone Y-Stents as Emergency Airway Management in Central Airway Stenosis Due to Secondary Thyroid Carcinoma: A Case Report.

作者信息

Elhidsi Mia, Soehardiman Dicky, Wibawanto Agung, Maruli Haris, Syahruddin Elisna

机构信息

Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Persahabatan National Respiratory Referral Hospital, Jakarta, Indonesia.

Indonesian Bronchoscopy Society, Perbronki, Jakarta, Indonesia.

出版信息

Case Rep Pulmonol. 2022 Nov 7;2022:6338073. doi: 10.1155/2022/6338073. eCollection 2022.

Abstract

Total airway obstruction in thyroid cancer is rare and has high morbidity and mortality. Airway management in such cases is challenging, especially in cases in which thyroid masses cannot be totally resected. It is important to choose the appropriate airway treatment modality. Currently, therapeutic rigid bronchoscopy procedures and endoluminal lasers, as well as airway stent insertion, are a management modality of near-total malignant airway obstruction. We report a rigid bronchoscopy procedure combined with laser and Y-stent silicone insertion in thyroid cancer with extension infiltration, as well as compression in the trachea covering the subglottic tracheal area up to the main carina and tracheo-bronchomalacia, manifesting as acute respiratory failure.

摘要

甲状腺癌导致的完全气道梗阻罕见,且发病率和死亡率高。此类病例的气道管理具有挑战性,尤其是在甲状腺肿块无法完全切除的情况下。选择合适的气道治疗方式很重要。目前,治疗性硬质支气管镜检查、腔内激光治疗以及气道支架置入是接近完全恶性气道梗阻的一种管理方式。我们报告了1例针对伴有浸润扩展、压迫气管(覆盖声门下气管区域直至主隆突)及气管支气管软化并表现为急性呼吸衰竭的甲状腺癌患者,采用硬质支气管镜检查联合激光及Y形硅胶支架置入的治疗过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4dd1/9663233/524ea5133823/CRIPU2022-6338073.001.jpg

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