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Lyu, Song, Hong, Oh, Shim, Lim, Lee, Koh, Kim, Kim, and Choi: Bronchoscopic Cryotherapy in Patients with Central Airway Obstruction
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2010; 68(1): 6-9.

Published online: 31 January 2010

DOI: https://doi.org/10.4046/trd.2010.68.1.6

Bronchoscopic Cryotherapy in Patients with Central Airway Obstruction

Jiwon Lyu, M.D., Jin Woo Song, M.D., Sang-Bum Hong, M.D., Yeon-Mok Oh, M.D., Tae Sun Shim, M.D., Chae-Man Lim, M.D., Sang Do Lee, M.D., Younsuck Koh, M.D., Woo Sung Kim, M.D., Dong Soon Kim, M.D., Chang Min Choi, M.D.

Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Address for correspondence: Chang Min Choi, M.D. Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 86, Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, Korea. Phone: 82-2-3010-5902, Fax: 82-2-3010-6968, ccm@amc.seoul.kr

Received 5 October 2009       Accepted 30 November 2009

Copyright © 2010. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Background

The efficacious use of interventional bronchoscope for patients with central airway obstruction due to malignant or benign lesions has been proven. Among many therapeutic bronchoscopic procedures, endobronchial cryotherapy is an established recanalization method for the obstruction of the respiratory tract. Recently, the use of this procedure has been increasing in Korea. However, limited data are available in the literature regarding its efficacy in Korea.

Methods

Thirty patients, who had been treated with a flexible cryoprobe for cryotherapy were enrolled; clinical characteristics and treatment outcomes were analyzed. The patients had been treated with the technique using nitrous oxide as a cryogen under local anesthesia. Objective outcomes were 3 different degrees of therapeutic success by use of follow-up bronchoscopic findings as follows: successful, partially successful, and unsuccessful response. Subjective outcomes were evaluated as an improvement in symptoms.

Results

The mean age of enrolled patients was 59±11 years and there was a male (22/30) dominance. Twenty-three patients had malignant tumor and 7 patients had benign lesions with central airway obstruction. Successful recanalization was achieved in 11 (37%) patients, and partially successful response was achieved in 15 (50%) patients. Dyspnea was improved in 84.2% (16/19) of patients. At least one respiratory symptom was resolved in 91.3% (21/23) patients. Seven patients (23.3%) needed additional bronchoscopic electrocautery because of the bleeding as a complication of cryotherapy.

Conclusion

Endobronchial cryotherapy is an effective and less expensive procedure for the management of central airway obstruction. However, the procedure should be performed under the preparing for an emergency situation, such as massive bleeding.

Keywords: Bronchoscopy, Cryotherapy, Airway Obstruction

Figures and Tables

Table 1
Assessment of treatment outcomes
trd-68-6-i001
Table 2
Baseline characteristics of the patients
trd-68-6-i002

NSCLC: non-small cell lung cancer; SCLC: small cell lung cancer; RUL: right upper lobe; RBI: right bronchus intermedius; RLL: right lower lobe; LUL: left upper lobe.

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