Cryorecanalization in Airway Obstruction: Initial Experience in a Medical Center

冷凍再通術於呼吸道阻塞的治療：一個醫學中心的經驗

陳克誠(Ke-Cheng Chen) ； 金盈君(Ying-Chun Chin) ； 蔡東明(Tung-Ming Tsai) ； 郭順文(Shuenn-Wen Kuo) ； 黃培銘(Pei-Ming Huang) ； 徐紹勛(Hsao-Hsun Hsu) ； 陳晉興(Jin-Shing Chen) ； 李章銘(Jang-Ming Lee) ； 賴鴻緒(Hong-Shiee Lai)

《胸腔醫學》 29卷1期 (2014/02) Pp. 1-7

摘要

前言：氣管狹窄是一個嚴重的疾病，常常會造成嚴重的併發症，甚至死亡。現今針對氣管狹窄有許多的治療方式，而冷凍治療是眾多方法中的其中一個方法，但是迄今在台灣治療經驗的報導仍不多。方法：從2010年一月至2012年六月，我們蒐集了在台大醫院裡接受冷凍治療的十二位病患，做完整的病例回顧以及統計分析。結果：所有的病患（n=12）都有達成氣道再通的目的。雖然高達7位病患需要再進一步做治療，我們的死亡率是零。少出血量更是冷凍治療的優勢。只有一位病患有較多的流血量，也適當地加以止血。結論：氣管狹窄是一個嚴重且棘手的疾病，面對氣管狹窄的病患時，可以考慮冷凍治療以及冷凍再通術。

關鍵字

冷凍再通術 ； 氣管腫瘤 ； 氣管狹窄 ； 氣管阻塞

並列摘要

Background: Endobronchial cryotherapy is an established recanalization method for stenoses of the respiratory tract. However, previous applications of cryotherapy have seldom been reported in Taiwan. In this study we demonstrate a newly developed cryoprobe allowing recanalization of tumor stenoses during a single intervention.Methods: We retrospectively reviewed the clinical characteristics and outcomes of 12 patients with endobronchial obstruction treated by cryosurgery between 2010 and 2012.Results: Three women and 9 men were included in our study. The mean age was 54 ± 15.9 years. The etiology of the obstruction included tumor (n=7), post-intubation (n=3), and tuberculosis (n=2). Ten patients were treated successfully (83.3%). Re-intervention was required in 6 patients (60%).Conclusions: This initial experience with cryosurgery for airway obstruction suggests that it can be used safely. It was effective in improving symptoms and reducing the severity of airway narrowing. Re-intervention was still required in some patients. Further study should be undertaken to determine factors that may be associated with success or failure, as well as the relative efficacy of cryosurgery compared with other endoscopic therapies.

並列關鍵字

cryorecanalization ； cryosurgery ； airway obstruction