Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, W/DC 201, 185 Pilgrim Road, Boston, MA 02215, USA.
Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, W/DC 201, 185 Pilgrim Road, Boston, MA 02215, USA.
Thorac Surg Clin. 2023 Aug;33(3):299-308. doi: 10.1016/j.thorsurg.2023.04.016. Epub 2023 May 29.
Excessive central airway collapse (ECAC) is a condition characterized by the excessive narrowing of the trachea and mainstem bronchi during expiration, which can be caused by Tracheobronchomalacia (TBM) or Excessive Dynamic Airway Collapse (EDAC). The initial standard of care for central airway collapse is to address any underlying conditions such as asthma, COPD, and gastro-esophageal reflux. In severe cases, when medical treatment fails, a stent-trial is offered to determine if surgical correction is a viable option, and tracheobronchoplasty is suggested as a definitive treatment approach. Thermoablative bronchoscopic treatments, such as Argon plasma coagulation (APC) and laser techniques (potassium-titanyl-phosphate [KTP], holmium and yttrium aluminum pevroskyte [YAP]) are a promising alternative to traditional surgery. However, further research is needed to assess their safety and effectiveness in humans before being widely used.
过度中央气道塌陷(ECAC)是一种在呼气时气管和主支气管过度狭窄的病症,可由 Tracheobronchomalacia(TBM)或过度动态气道塌陷(EDAC)引起。中央气道塌陷的初始标准治疗方法是解决任何潜在疾病,如哮喘、COPD 和胃食管反流。在严重情况下,当药物治疗失败时,会进行支架试验以确定手术矫正是否可行,并建议进行气管支气管成形术作为确定性治疗方法。热消融支气管镜治疗,如氩等离子体凝固(APC)和激光技术(钾钛磷酸盐[KTP]、钬和钇铝石榴石[YAP])是传统手术的一种有前途的替代方法。然而,在广泛应用之前,还需要进一步研究来评估它们在人类中的安全性和有效性。