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Comparison of two new techniques for the management of malignant central airway obstruction: argon plasma coagulation with mechanical tumor resection versus cryorecanalization

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Abstract

Background

The development of central airway obstruction during malignant diseases is an important cause of morbidity and mortality. Endobronchial therapies can decrease the patient’s symptoms and improve quality of life. Here, we compare airway recanalization methods: argon plasma coagulation with mechanical tumor resection (APC + MTR) and cryorecanalization (CR efficiency, complications, restenosis rate, and time to restenosis) in patients with malignant exophytic endobronchial airway obstruction.

Methods

A total of 89 patients were included who were admitted to our hospital between 2005 and 2012. The data were analyzed retrospectively. Initially, a CR procedure was performed in 52 patients using rigid bronchoscopy under general anesthesia; the APC + MTR procedure was performed in 37 patients with malignant airway obstruction.

Results

The airway patency rate with APC + MTR was 97.3% (n = 36) and CR was 80.8% (n = 42). The APC + MTR procedure was more effective than CR for recanalization of malignant endobronchial exophytic airway obstruction. Additionally, the achievement rate of airway patency with APC + MTR was significantly higher in tumors with distal bronchial involvement. There was no statistically significant difference between groups in terms of complications, restenosis rate, and time to restenosis.

Conclusions

The APC + MTR procedure is preferred over CR to introduce and maintain airway patency in patients with malignancy-related endobronchial exophytic airway obstruction.

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Acknowledgements

We would like to thank Zafer Aktaş for his kind help and advice in the course of the present study.

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Authors and Affiliations

  1. Department of Chest Disease, Ankara Atatürk Chest Disease and Thoracic Surgery Training and Research Hospital, 06290, Ankara, Turkey

    Derya Kızılgöz & Fatih Seğmen

  2. Department of Chest Disease and Interventional Pulmonology, Ankara Atatürk Chest Disease and Thoracic Surgery Training and Research Hospital, Ankara, Turkey

    Zafer Aktaş, Aydın Yılmaz & Ayperi Öztürk

Authors
  1. Derya Kızılgöz
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  2. Zafer Aktaş
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  3. Aydın Yılmaz
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  4. Ayperi Öztürk
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  5. Fatih Seğmen
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Correspondence to Derya Kızılgöz.

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Disclosures

Derya Kızılgöz, Zafer Aktaş, Aydın Yılmaz, Ayperi Öztürk, and Fatih Seğmen declare that they have no conflicts of interest or financial ties to disclose.

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Kızılgöz, D., Aktaş, Z., Yılmaz, A. et al. Comparison of two new techniques for the management of malignant central airway obstruction: argon plasma coagulation with mechanical tumor resection versus cryorecanalization. Surg Endosc 32, 1879–1884 (2018). https://doi.org/10.1007/s00464-017-5877-2

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