Rigid bronchoscopic interventions for central airway obstruction – An observational study
Background: Central airway obstruction (CAO) is a significant cause of morbidity and mortality in patients with thoracic malignancies. In this prospective study, we describe the role of rigid bronchoscopy (RB) in the multimodality management of CAO. Methods: Prospective description of different rigi...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2020-01-01
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| Series: | Lung India |
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| Online Access: | http://www.lungindia.com/article.asp?issn=0970-2113;year=2020;volume=37;issue=2;spage=114;epage=119;aulast=Khan |
| _version_ | 1819091211149901824 |
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| author | Ajmal Khan Zia Hashim Mansi Gupta Hira Lal Aarti Agarwal Alok Nath |
| author_facet | Ajmal Khan Zia Hashim Mansi Gupta Hira Lal Aarti Agarwal Alok Nath |
| author_sort | Ajmal Khan |
| collection | DOAJ |
| description | Background: Central airway obstruction (CAO) is a significant cause of morbidity and mortality in patients with thoracic malignancies. In this prospective study, we describe the role of rigid bronchoscopy (RB) in the multimodality management of CAO. Methods: Prospective description of different rigid bronchoscopic techniques used for CAO between July 2016 and July 2019. Results: A total of 152 procedures (124 therapeutic/palliative and 28 diagnostics) in 111 adults and 10 pediatric patients were performed. The mean age in 111 adults (66 males) and 10 pediatric (5 males) patients were 45.4 ± 15.8 (range 16–80) and 5.4 ± 3.6 (range 1–10) years, respectively. Palliation of the airway obstruction (48.8%) and establishment of diagnosis (23.2%) were the main indications of RB in our study. Mechanical debulking in 53 (57%) and airway dilatation in 40 (43%) patients were the most utilized interventions during the palliative or therapeutic RB. There was a significant decrease in mean (modified Medical Research Council) dyspnea scale from 3.9 ± 1.0 to 1.42 ± 0.63 and increase in mean Visual Analogue Scale from 2.06 ± 0.74 to 8.7 ± 0.54 after the procedure (P < 0.0001). Additional therapy was undertaken in 38 (31.4%) of 121 patients, and surgical excision was the primary form of definitive treatment in 17 patients Moderate bleeding was encountered in 13.3% of the procedures mainly in the diagnostic RB. The mean procedure duration was 28.4 (range, 11–49) min and 13.2 (7–22) min in the adults and pediatric patients, respectively. A total of 31 patients succumbed to the illness due to the progressive nature of their disease. Conclusions: An individualized approach to interventional procedures is safe and effective way to achieve and maintain palliation of CAO. RB with multimodality treatment achieves the goal in majority of the patients. |
| first_indexed | 2024-12-21T22:36:07Z |
| format | Article |
| id | doaj.art-cda9b82e435640319e725328df0b930b |
| institution | Directory Open Access Journal |
| issn | 0970-2113 0974-598X |
| language | English |
| last_indexed | 2024-12-21T22:36:07Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Lung India |
| spelling | doaj.art-cda9b82e435640319e725328df0b930b2022-12-21T18:47:57ZengWolters Kluwer Medknow PublicationsLung India0970-21130974-598X2020-01-0137211411910.4103/lungindia.lungindia_454_19Rigid bronchoscopic interventions for central airway obstruction – An observational studyAjmal KhanZia HashimMansi GuptaHira LalAarti AgarwalAlok NathBackground: Central airway obstruction (CAO) is a significant cause of morbidity and mortality in patients with thoracic malignancies. In this prospective study, we describe the role of rigid bronchoscopy (RB) in the multimodality management of CAO. Methods: Prospective description of different rigid bronchoscopic techniques used for CAO between July 2016 and July 2019. Results: A total of 152 procedures (124 therapeutic/palliative and 28 diagnostics) in 111 adults and 10 pediatric patients were performed. The mean age in 111 adults (66 males) and 10 pediatric (5 males) patients were 45.4 ± 15.8 (range 16–80) and 5.4 ± 3.6 (range 1–10) years, respectively. Palliation of the airway obstruction (48.8%) and establishment of diagnosis (23.2%) were the main indications of RB in our study. Mechanical debulking in 53 (57%) and airway dilatation in 40 (43%) patients were the most utilized interventions during the palliative or therapeutic RB. There was a significant decrease in mean (modified Medical Research Council) dyspnea scale from 3.9 ± 1.0 to 1.42 ± 0.63 and increase in mean Visual Analogue Scale from 2.06 ± 0.74 to 8.7 ± 0.54 after the procedure (P < 0.0001). Additional therapy was undertaken in 38 (31.4%) of 121 patients, and surgical excision was the primary form of definitive treatment in 17 patients Moderate bleeding was encountered in 13.3% of the procedures mainly in the diagnostic RB. The mean procedure duration was 28.4 (range, 11–49) min and 13.2 (7–22) min in the adults and pediatric patients, respectively. A total of 31 patients succumbed to the illness due to the progressive nature of their disease. Conclusions: An individualized approach to interventional procedures is safe and effective way to achieve and maintain palliation of CAO. RB with multimodality treatment achieves the goal in majority of the patients.http://www.lungindia.com/article.asp?issn=0970-2113;year=2020;volume=37;issue=2;spage=114;epage=119;aulast=Khancentral airway obstructiondiagnostic rigid bronchoscopyinterventional pulmonologylung cancertherapeutic rigid bronchoscopytracheal stenosis |
| spellingShingle | Ajmal Khan Zia Hashim Mansi Gupta Hira Lal Aarti Agarwal Alok Nath Rigid bronchoscopic interventions for central airway obstruction – An observational study Lung India central airway obstruction diagnostic rigid bronchoscopy interventional pulmonology lung cancer therapeutic rigid bronchoscopy tracheal stenosis |
| title | Rigid bronchoscopic interventions for central airway obstruction – An observational study |
| title_full | Rigid bronchoscopic interventions for central airway obstruction – An observational study |
| title_fullStr | Rigid bronchoscopic interventions for central airway obstruction – An observational study |
| title_full_unstemmed | Rigid bronchoscopic interventions for central airway obstruction – An observational study |
| title_short | Rigid bronchoscopic interventions for central airway obstruction – An observational study |
| title_sort | rigid bronchoscopic interventions for central airway obstruction an observational study |
| topic | central airway obstruction diagnostic rigid bronchoscopy interventional pulmonology lung cancer therapeutic rigid bronchoscopy tracheal stenosis |
| url | http://www.lungindia.com/article.asp?issn=0970-2113;year=2020;volume=37;issue=2;spage=114;epage=119;aulast=Khan |
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