title: [Interventional Bronchoscopies for the Treatment of 112 Cases with Complex Malignant Central Airway Diseases Involved in Bifurcation].
abstract: BACKGROUND
  It is very difficult to deal with the comprehensive central airway diseases, especially the malignant airway obstruction. The aim of this study is to explore the clinical effects of multiple interventional bronchoscopies for the treatment of 112 cases with comprehensive malignant central airway diseases so as to evaluate the clinical applications of thermoablation and cryosurgery.
  
  
  METHODS
  The 112 cases with malignant airway diseases retrospectively reviewed for bronchoscopic interventions performed in more than two lesions of carina and/or bifurcation. The age was from 22 to 90 years, which including 55 cases with squamous carcinoma (SQ), 16 adenocarcinoma (AD), 15 adenocystic carcinoma (ACC), 10 metastasis tumor (MT), 8 small cell lung carcinoma (SCLC) and 8 mixed carcinoma (MC). All bronchoscopic interventions such as argon plasma coagulation (APC), cryosurgery, electronic snare and stenting were performed under rigid bronchoscopy combined with electric bronchoscopy in general anesthesia.
  
  
  RESULTS
  The 460 bronchoscopic procedures were successfully performed in 112 cases. Cryosurgery and APC were the most used in every group. Stent was more common in patients with MT, balloon dilation was more common in patients with ACC and AD. Electric snare and radioactive seeds implantation were frequently used in cases with SCLC. Trachea stricture is more severe in MT than that in others, while bronchus stricture is more severe than that of trachea in SQ and ACC group. Karnofsky performance score (KPS) is lower and shortness of breath score (SBS) is higher in MC, MT and SCLC group. Trachea and bronchus stricture is improved after comprehensive treatment in 5 groups except of mixed group. KPS increased and SS decreased significantly in 5 groups except of adenocarcinoma. In follow-up, the overall survival time (OS) is 15 months and median survival time is 10 months, especially OS is 28.4 months in ACC and 21.7 months in AD, 8.9 months in SCLC and 7.4 months in mixed group.
  
  
  CONCLUSIONS
  APC combination with Cryosurgery and other bronchoscopic interventions are indicated for the treatment of complex or difficult airway diseases whether they are located in trachea or bronchus. It is a safe and rapid during procedure.
authors.affiliation: Department of Medical Oncology, Meitan General Hospital, Beijing 100028, China.
authors.forename: Hongwu
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Medical Oncology, Meitan General Hospital, Beijing 100028, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Zhang
authors.affiliation: Department of Medical Oncology, Meitan General Hospital, Beijing 100028, China.
authors.forename: Dongmei
authors.initials: D
authors.lastname: Li
authors.affiliation: Department of Medical Oncology, Meitan General Hospital, Beijing 100028, China.
authors.forename: Meimei
authors.initials: M
authors.lastname: Tao
authors.affiliation: Department of Medical Oncology, Meitan General Hospital, Beijing 100028, China.
authors.forename: Jieli
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Medical Oncology, Meitan General Hospital, Beijing 100028, China.
authors.forename: Hang
authors.initials: H
authors.lastname: Zou
authors.affiliation: Department of Medical Oncology, Meitan General Hospital, Beijing 100028, China.
authors.forename: Yunzhi
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of Medical Oncology, Meitan General Hospital, Beijing 100028, China.
authors.forename: Sujuan
authors.initials: S
authors.lastname: Liang
authors.affiliation: Department of Medical Oncology, Meitan General Hospital, Beijing 100028, China.
authors.forename: Xiuyun
authors.initials: X
authors.lastname: Bai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000601:surgery*; D057908:Argon Plasma Coagulation; D001999:Bronchoscopy; D003452:Cryosurgery; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult