OUR ENDOBRONCHIALLY TREATED PATIENTSOUR ENDOBRONCHIALLY TREATED PATIENTS

Erdoğan ÇetinkayaErdoğan Çetinkaya,, Mehmet Akif Özgül, Mehmet Akif Özgül, Güler Özgül, Güler Özgül, Ertan Çam, Atayla Gençoğlu, Gülşah GünlüoğluErtan Çam, Atayla Gençoğlu, Gülşah Günlüoğlu

Yedikule Chest Diseases And Yedikule Chest Diseases And Chest Surgery Training and Research Hospital , Chest Surgery Training and Research Hospital ,

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Central airway stenosisCentral airway stenosis

Benign or malignant etiology may cause central airway Benign or malignant etiology may cause central airway stenosis.stenosis.

The most common cause of malignant airway stenosis is The most common cause of malignant airway stenosis is bronchogenic carcinoma. Thyroid carcinoma and bronchogenic carcinoma. Thyroid carcinoma and esophageal cancer and occasionally endobronchial esophageal cancer and occasionally endobronchial metastasis may be the reason. metastasis may be the reason.

Granulation tissue due to endotracheal intubation Granulation tissue due to endotracheal intubation (postintubation stenosis), foreign bodies, (postintubation stenosis), foreign bodies, tracheobronchomalacia are the main causes of benign tracheobronchomalacia are the main causes of benign airway stenosis airway stenosis

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PurposePurpose

Cases have been evaluated retrospectivelyCases have been evaluated retrospectively

MethodMethod

Review of endobronchially treated cases Review of endobronchially treated cases in our clinic between January 2009 and in our clinic between January 2009 and January 2010. January 2010.

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ResultsResults

We studied 57 patients treated endobronchially in our We studied 57 patients treated endobronchially in our interventional bronchoscopy unit.interventional bronchoscopy unit.

Average age of the patients were 56 ± 13 ,Average age of the patients were 56 ± 13 ,13 females and 44 males. 13 females and 44 males.

42 (73,7%) of the cases were diagnosed with lung 42 (73,7%) of the cases were diagnosed with lung carcinoma. 15 (26,3%) had diagnosis of diseases other carcinoma. 15 (26,3%) had diagnosis of diseases other than lung cancer.than lung cancer.

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3

4111

5

Postentübasyonstenozu

Benign tümör

Tiroid kanseri

Ösefaguskanseri

Polanjan guatr

Yabancı cisim

Postentubation stenosis Benign tumors

Thyroidcarcinoma Esophageal cancer Intrathoracic goitre

Foreign body

Diseases other than lung cancer that cause airway Diseases other than lung cancer that cause airway obstructionobstruction

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Endobronchial stenosisEndobronchial stenosis n(%)n(%)Tracheal Tracheal 12 (21%)12 (21%)

Right bronchial system Right bronchial system 16 (28%)16 (28%)

Left bronchial system Left bronchial system 13 (22%)13 (22%)

Right and left main bronchi and Right and left main bronchi and carinal carinal

3 ( 5%)3 ( 5%)

Tracheal, carinal, right and left Tracheal, carinal, right and left main bronchimain bronchi

9 (15%)9 (15%)

Tracheal and right main bronchus Tracheal and right main bronchus

TotalTotal

4 ( 7%)4 ( 7%)

5757

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Endobronchial stenosisEndobronchial stenosis

Endobronchial stenosis Endobronchial stenosis – 12 (21%) by extrinsic lesions, 12 (21%) by extrinsic lesions, – 33 (57%) intrinsic and 33 (57%) intrinsic and – 12 (21%) mixed 12 (21%) mixed

Endobronchial stents were placed to 21 (36,8%) of the Endobronchial stents were placed to 21 (36,8%) of the treated patients. Endobronchial treatment modalities treated patients. Endobronchial treatment modalities other them stents were performed to 36 (63,2%) of the other them stents were performed to 36 (63,2%) of the patients. patients.

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Stent Stent nn

Slicon dumon YSlicon dumon Y 1111

Slicon dumon trachealSlicon dumon tracheal 44

Slicon dumon stenotic Slicon dumon stenotic 33

AlveolusAlveolus 33

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47 sessions of argon plasma coagulation, cryotherapy or 47 sessions of argon plasma coagulation, cryotherapy or combinations were performedcombinations were performed..

8 sessions of electrocautery snare, 8 sessions of electrocautery snare,

3 sessions of laser, 3 sessions of laser,

21 sessions of stent placement, 21 sessions of stent placement,

5 sessions of stent removal were performed. 5 sessions of stent removal were performed.

Endobronchial treatment

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RK, 62, M

DIAGNOSED WITH INOPERABLE LUNG CARCINOMA. HE HAD 4-CYCLE CHEMOTHERAPY AND 75 FRACTIONS OF RADIOTHERAPY. HE WAS ADMİTTED TO OUR CLINIC WITH RECENT SHORTNESS OF BREATH

Case 1

1111

RK

Case 1

1212

PET/CT SCANS, BEFORE AND AFTER TREATMENT

RK

Case 1

1313

MEDICAL TREATMENT FOLLOWED BY STENT REMOVAL

RK

Case 1

1414

E K, 56, MShortness of breath,Had no previous history of any lung disease, his complaints progressed for the past 2 years. Referred to our clinic with suspected lung carcinoma

Case 2

1515

MIXED STENOSIS

E K, 56, M

Case 2

1616Novatech Dumon Y Stent

E K,56

Case 2

1717

3D, CORONAL BT

•SD, 49, M•Subdural hematoma, intracerebral hemorrhage after falling from a tree•He was intubated for 10 days in the ICU •History of Type I DM, CAD (13 years)•Smoker

Complex stenosis

Case3

1818

SD, 49, M

Case 3

1919

16X14X16 STENOTIC STENT

Distal part of the stenotic stent has the diameter of 14 or 16 mm. Distal parts are 15mm long and the stenotic middle part is 20mm long.

Case 3

2020

Dilatation and before stent With stent

Case 3

2121

Case 3

2222

HŞ, 59, M3 YEARS AGO HE WAS DIAGNOSED WITH INOPERABLE SQUAMOUS CELL LUNG CANCER AFTER BEING INVESTIGATED FOR SHORTNESS OF BREATH AND BACK PAIN.. HE HAD 6-CYCLE CHEMOTHERAPY AND 30 FRACTIONS OF RADIOTHERAPY. IN 2008 PROGRESSION OF HIS DISEASE WAS DETECTED WITH PET/CT SCANS. HE RECEIVED ONLY 3 CYLES OF CHEMOTHERAPY. HE WAS REFERRED TO OUR CLINIC FOR INTERVENTIONAL TREATMENT AND STENTING.

Case4

2323

ComplicationsComplications

Complications observed were fiberoptic Complications observed were fiberoptic bronchoscopy damage occurred during bronchoscopy damage occurred during one session and death of one patient due one session and death of one patient due to respiratory failure not related to our to respiratory failure not related to our procedure but occurred during procedure but occurred during endobronchial treatment. endobronchial treatment.

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ConclusionConclusion

Endobronchial treatment is a life saving Endobronchial treatment is a life saving and effective modality that enhances the and effective modality that enhances the quality of life of the patients with air way quality of life of the patients with air way obstruction.obstruction.