Hua Shao-Peng, Jia Xiu-Jie, Hu Xiao-Fang, Liu Hui, Zhao Xin-Guo, Mao Jia
Department of Tuberculosis, Affiliated Wuxi Fifth Hospital of Jiangnan University (The Fifth People's Hospital of Wuxi), Wuxi, 214007, Jiangsu, China.
Department of Emergency, Wuxi No.2 People's Hospital (Jiangnan University Medical Center), No. 68 of Zhongshan Street, Liangxi District, Wuxi, 214002, Jiangsu, China.
Updates Surg. 2025 Apr;77(2):559-566. doi: 10.1007/s13304-024-02031-x. Epub 2024 Dec 13.
To compare the efficacy and safety of cryorecanalisation and cryoablation using flexible bronchoscopy for the treatment of tumor-like endobronchial tuberculosis (EBTB). Patients with tumor-like EBTB (104) were randomly divided into a cryorecanalisation (54 patients) or cryoablation (50 patients) group to assess the differences in efficacy and complications between the treatments. The cryorecanalisation and cryoablation treatments' therapeutic efficacies were 81.5% and 48.0%, respectively (p = 0.000); in patients with less than moderate obstruction (≤ 50%), the therapeutic efficacies were 92.9% and 88.9%, respectively (p = 1.000). In patients with more than moderate obstruction (> 50%), cryorecanalisation and cryoablation's therapeutic efficacies were 77.5% and 25.0%, respectively (p = 0.000). The number of treatments in the cryorecanalisation and cryoablation groups were 2.46 ± 1.06 and 3.26 ± 0.75, respectively (p = 0.000). The main complication of the treatment protocol in both groups was bleeding, and the overall bleeding rate was 96.2% and 16.0% in the cryorecanalisation and cryoablation groups, respectively (p = 0.000). Cryorecanalisation via flexible bronchoscopy improved the outcome of patients with tumor-like EBTB and reduced the number of treatments required compared with cryoablation; however, it had a higher bleeding rate and the potential risk of severe bleeding.
比较使用可弯曲支气管镜进行冷冻再通术和冷冻消融术治疗肿瘤样支气管内膜结核（EBTB）的疗效和安全性。将104例肿瘤样EBTB患者随机分为冷冻再通术组（54例）和冷冻消融术组（50例），以评估两种治疗方法在疗效和并发症方面的差异。冷冻再通术和冷冻消融术的治疗有效率分别为81.5%和48.0%（p = 0.000）；在阻塞程度小于中度（≤50%）的患者中，治疗有效率分别为92.9%和88.9%（p = 1.000）。在阻塞程度大于中度（>50%）的患者中，冷冻再通术和冷冻消融术的治疗有效率分别为77.5%和25.0%（p = 0.000）。冷冻再通术组和冷冻消融术组的治疗次数分别为2.46±1.06和3.26±0.75（p = 0.000）。两组治疗方案的主要并发症均为出血，冷冻再通术组和冷冻消融术组的总体出血率分别为96.2%和16.0%（p = 0.000）。与冷冻消融术相比，通过可弯曲支气管镜进行冷冻再通术改善了肿瘤样EBTB患者的治疗效果并减少了所需的治疗次数；然而，其出血率较高且存在严重出血的潜在风险。
