PURPOSE:Currently, effective methods for the treatment of stenoses of the respiratory tract caused by exophytic tumors include laser therapy, mechanical recanalization with rigid bronchoscopic debulking, photodynamic therapy, and cryotherapy. However, previous applications of cryotherapy have not been immediately effective, requiring a second clean-up procedure several days later to finally obtain sufficient recanalization. In this study we demonstrate a newly developed cryoprobe (Erbockryo, ERBE Medizintechnik GMbH, Tubingen, Germany) allowing recanalization of tumor stenoses during a single intervention.
METHODS:In this prospective study flexible bronchoscopy was used for cryorecanalization of 28 patients with high-grade stenoses of the respiratory tract from exophytic tumors. Tumor tissue was frozen on the tip of the probe (- 89.5° C) and subsequently removed from the surrounding respiratory tract tissue through retraction of the probe. Procedures were carried out on sedated (midazolam 5 mg ev), spontaneously breathing patients.
RESULTS:25 patients of the 28 patients (89.2%) were successfully or partially successfully treated. Tumor bleeding occurred in 6 patients but was stopped with argon plasma coagulator treatment in all patients not requiring rigid bronchoscopy.
CONCLUSION:Cryorecanalization with the newly developed cryoprobe permits effective, safe and inexpensive therapy of endobronchial stenoses of the respiratory tract.
CLINICAL IMPLICATIONS:Cryorecanalization might offer many advantages in the interventional therapy of stenosing tumors of the respiratory tract: use of flexible technology, immediate effectiveness, low rick of complications, and low costs in comparison with those of other recanalization methods.
DISCLOSURE:Claudio Micheletto, No Financial Disclosure Information; No Product/Research Disclosure Information