Background: Main airway severe obstruction is a problem facing difficulty flexible bronchoscope because the patient is not able to breath smoothly under prostration, and death from suffocation is a frequent outcome. Managing the airway of patients with critical tracheal stenosis remains a formidable challenge to bronchoscopists. This study is to evaluate the application and efficacy of argon plasma coagulation (APC) and cryoextraction for the treatment of endobronchial neoplasma under rigid bronchoscope combined with flexible bronchoscope.
Methods: Two groups of airway pathologically proved neoplasma were retrospectively reviewed for the different endobronchial intervation modalities. Group A: Argon plasma coagulation (APC) and cryoextraction were used for the treatment of endobronchial neoplasma under rigid bronchoscope combined with electronic bronchoscope in 19 cases with tracheobronchial carcinoma. Rigid bronchoscope was inserted into trachea with general anesthesia. Then the endobronchial tumor was removed by the combination APC and cryoextraction. Group B: APC and grasp or cryoextraction were used for the debulking of endobronchial tumor under flexible bronchoscope in 20 cases with airway tumor.
Results: Both tracheal and bronchial obstruction were more severe in Group A than those in Group B, but the tumor debulking was higher for the first time in Group A than in Group B. There were no difference on debulking volume between trachea and bronchus in the same group. The procedures were less complex in Group A than in Group B. The clinical improvement was better in Group A than in Group B. There were no severe complications directly related to the procedures.
Conclusions: The combination of APC and cryoextraction is a rapid and effective method for the treatment of endoluminal airway tumor under rigid bronchoscope combined with electronic bronchoscope. Cryoextraction could rapidly debulk airway tumor and APC could effectively ablate tumor and stop bleeding. Electronic bronchoscope is used for the maintenance after rigid bronchoscope and for the treatment of slightly airway obstruction.