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Abstract: Poster Presentations |

ARGON PLASMA COAGULATION FOR THE MANAGEMENT OF ENDOBRONCHIAL LESIONS VIA FLEXIBLE BRONCHOSCOPY FREE TO VIEW

Su-Ying Low, MB, BCh*; Philip Eng, MBBS
Author and Funding Information

Singapore General Hospital, Singapore, Singapore


Chest


Chest. 2005;128(4_MeetingAbstracts):323S. doi:10.1378/chest.128.4_MeetingAbstracts.323S-a
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Abstract

PURPOSE:  To evaluate the effectiveness and safety of argon plasma coagulation (APC) via flexible bronchoscopy (FFB) for the management of both benign and malignant airway lesions.

METHODS:  Retrospective review of consecutive case records of all patients treated at the Singapore General Hospital with APC via FFB from May 2002 to December 2004.

RESULTS:  A total of 35 patients underwent 41 procedures, all of which were performed via flexible bronchoscopy under conscious sedation. Mean age was 62.4±16.4years, of whom 25/35 (71.4%) were male. Of the 41 procedures, 25/41 (61%) were performed on an outpatient basis. 2/41 (4.9%) of patients were in the intensive care unit requiring mechanical ventilation for respiratory failure. Majority of patients 27/35 (77.1%) had malignant endobronchial lesions. The remaining 8/35 (22.9%) patients had benign airway lesions due to granulation tissue or benign strictures causing airway obstruction. The mean APC procedure time was 32.7±20minutes. There was no procedure-related morbidity or mortality. All patients experienced immediate symptomatic improvement in their dyspnoea. The 2 patients who required mechanical ventilation could be weaned off the ventilator immediately post procedure and eventually discharged home. Repeat APC procedures were required in 4 patients (2 patients needed 2 procedures, 2 patients needed 3 procedures) to maintain airway patency. The median time between each procedure was 63days (range 23-288days). Five patients proceeded on to have rigid bronchoscopy (with or without NdYAG laser application and stent deployment) for further management of their airway obstruction.

CONCLUSION:  APC can be used to help restore airway patency for both the palliation of airway obstruction in malignant diseases and treatment of benign lesions. It is a safe, simple, and economic alternative to the current available array of therapeutic bronchoscopic modalities. However, repeated procedures may be required to maintain airway patency.

CLINICAL IMPLICATIONS:  APC is a useful adjunct for the management of both benign and malignant airway problems which can be safely and effectively performed via FFB under conscious sedation.

DISCLOSURE:  Su-Ying Low, None.

Wednesday, November 2, 2005

12:30 PM - 2:00 PM


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