Author/Editor		Debeljak, Andrej; Triller, Nadja; Kecelj, Peter; Letonja, Saša
Title		Paliativno bronhoskopsko zdravljenje tumorskega zoženja velikih dihalnih poti
Translated title		Palliative bronchoscopic treatment of tumour central airways stenosis
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 72, št. 7-8
Publication year		2003
Volume		str. 435-8
Language		slo
Abstract		Background. This article presents our three year experience with bronchoscopic management of central bronchial tumours stenosis. Methods. In the years 2000, 2001, and 2002, 52 patients (43 men, 9 women), aged 62.3 ± 10.8 years with central airway obstruction because of primary or secondary malignant tumours in 47 cases (90%) and benign diseases in 5 (10%) were treated. Topical anaesthesia with Lidocaine in all 52 patients where flexible bronchoscopes Olympus were applied was used. Additionally, Fentanyl or Diprivane were used in 25patients where rigid bronchoscopy (Storz) was performed. Mechanical removaland electrocautery resection (Olympus) were used for tumour resection. In 2 patients Polyflex stent (Rusch) was introduced into the trachea. Results. We treated 17 (33 %) tumours in the trachea, 14 (27%) in the right, 15 (29%) in the left main bronchi and 6 (11%) in more peripheral bronchi. The combination of mechanical removal and electrocautery was applied in 32 (61%), mechanical removal alone in 4 (8%) and electrocautery alone in 16 (31%) of patients. Symptomatic relief was achieved in 41 (79%) patients. In 47 patients with malignant tumours bronchoscopic intervention was applied during the first diagnostic procedure 28 times (60%), after additional surgery, radiotherapy or chemotherapy 14 times (30%) and between additional therapeutic interventions 5 times (10%). The procedure had to be terminated in one patient due to hypoxemia. There was no immediate mortality. Conclusions. Mechanical desobstruction in combination with electrocautery through the flexible and/or rigid bronchoscopes and stent introduction in patients with central airways tumours are efficient and rather safe palliative procedures.
Summary		Izhodišča. Želeli smo prikazati naše triletne izkušnje z bronhoskopskim zdravljenjem zoženj zaradi centralnih bronhialnih tumorjev. Metode. V letih 2000, 2001 in 2002 smo zdravili 52 bolnikov, 43 moških, 9 žensk, starih 62,3 ± 10,8 leta z zoženjem centralnih dihalnih poti zaradi primarnega ali sekundarnega malignega tumorja 47 (90%) ali benignih bolezni 5 (10%). Uporabljali smo lokalno anestezijo z lidokainom pri vseh 52 bolnikih, pregledanih z upogljivimi instrumenti Olympus. Dodatno smo 25 bolnikom, ki smo jih bronhoskopirali s togim bronhoskopom Storz, dali tudi fentanil ali diprivan. Tumor smo odstranjevali mehansko in z elektroresekcijo (Olympus). Pri dveh bolnikih smo vstavili v sapnik opornico (Rusch). Rezultati. Zdravili smo 17 (33%) bolnikov s tumorjem v sapniku, 14 (27%) v desnem, 15 (29%) v levem glavnem bronhiju ter 6 (11%) v bo j perifernih bronhijih. Kombinacijo mehanične odstranitve in elektroresekcije smo uporabili pri 32 (61%), samo mehanično odstranitevpri 4 (8%) in samo elektroresekcijo pri 16 (31%) bolnikih. Simptomatsko izboljšanje smo dosegli pri 41 (79%) bolnikih. Pri 47 bolnikih z malignimi boleznimi smo bronhoskopsko zdravljenje uporabili ob prvem diagnostičnem posegu pri 28 (60%), po dodatnem kirurškem zdravljenju, obsevanju ali kemoterapiji pri 14 (30%) in med drugimi načini zdravljenja pri 5 (10%) bolnikov. Zaradi hipoksemije smo morali pri enem bolniku poseg prekiniti. Medposegom ni nihče umrl. Zaključki. Mehanična in elektrokavterska odstranitev centralnega bronhialnega tumorja ter vstavljanje opornic z uporabo upogljivega in/ali togega bronhoskopa so učinkoviti in relativno varni načini simptomatskega zdravljenja.
Descriptors		BRONCHIAL NEOPLASMS BRONCHOSCOPY TRACHEAL NEOPLASMS PALLIATIVE CARE RETROSPECTIVE STUDIES