Cardiothoracic Surgery: Cardiothoracic Surgery |

Usefulness of Emergent Intervention Under Rigid Bronchoscopy for Central Airway Obstruction Due to Undiagnosed and Untreated Neoplastic Tumor FREE TO VIEW

Makoto Takahama, MD; Michitaka KImura, MD; Ryu Nakajima, MD; Ryoji Yamamoto, MD
Author and Funding Information

Osaka City General Hospital, Osaka, Japan

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):36A. doi:10.1016/j.chest.2016.08.043
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SESSION TITLE: Cardiothoracic Surgery

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: To estimate usefulness of emergent intervention under rigid bronchoscopy for central airway obstruction, we retrospectively analyzed the results of emergent rigid bronchoscopic intervention for symptomatic malignant tumors obstructing the central airway as an initial treatment.

METHODS: We performed rigid bronchoscopic interventions on 307 patients with symptomatic central airway obstructions between January 2007 and December 2015. Among them, we enrolled 21 patients (15 males, 71.4%; median age, 52 years) who underwent emergent debulking of tumors using rigid bronchoscope on the day they were referred to our institution prior to a definitive treatment. The primary sites of the tumor were the trachea in 15 patients and the carina in 6. We reviewed these patients and assessed their clinical characteristics and outcomes retrospectively.

RESULTS: All of them recovered from dyspnea immediately thereafter and none of them developed postoperative complications. We histopathologically confirmed that the obstructions comprised adenoid cystic carcinoma (n = 12), squamous cell carcinoma (n = 5) and others (n = 4). As a definitive treatment, 7 patients received chemoradiotherapy, 6 patients received radiotherapy, and 6 patients received operations after the estimation of tumor staging. The radical operative procedures were left sleeve pneumonectomy and tracheal resection in one and four patients, respectively. Two elderly patients declined the preceding treatment.

CONCLUSIONS: Emergency rigid bronchoscopic core out of malignant neoplastic obstructions of the central airway appears to be a safe initial treatment prior to a preceding definitive treatment.

CLINICAL IMPLICATIONS: Emergent therapeutic rigid bronchoscopy resulted in a marked improvement, in dyspnea and atelectasis before a radical procedure.

DISCLOSURE: The following authors have nothing to disclose: Makoto Takahama, Michitaka KImura, Ryu Nakajima, Ryoji Yamamoto

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