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Clinical InvestigationsEndobronchial Argon Plasma Coagulation for Treatment of Hemoptysis and Neoplastic Airway Obstruction
Section snippets
Materials and Methods
For this study, endobronchial therapy with APC was indicated forpatients with hemoptysis or symptomatic endoluminal airway obstruction. Patients with hemoptysis were eligible for this study if they met allof the following criteria: (1) bleeding originated with in thetracheobronchial tree; (2) the site of bleeding was identifiable duringflexible bronchoscopy; and (3) there was an absence of coagulopathy or other medically correctable causes of hemoptysis. Patients with obstructing airway
Results
From November 1998 to April 2000, 60 patients underwent 70endobronchial APC treatments. Patients' demographic characteristics, diagnoses, and locations of endoluminal airway lesions are shown inTable 1.
Conscious sedation with out endotracheal intubation was used in allpatients except four, who were receiving mechanical ventilation in the ICUs because of respiratory failure caused by their underlying disease. The first author performed all the bronchoscopic interventions. Fifty-seven treatments
Discussion
APC has been used for > 10 years in open surgery,14laparoscopy,15 and GI endoscopy.16 This isthe first study (to our knowledge) that reports on the feasibility and effectiveness of APC for hemostasis and debulking of endoluminaltracheobronchial lesions through the flexible bronchoscope. Theexcellent safety profile, readiness of use, and relatively low costmake APC most suitable for therapeutic applications through theflexible bronchoscope in the outpatient setting. This study alsoattests to the
References (25)
- et al.
Incidence of local recurrence and second primary tumors in resected stage I lung cancer
Thorac Cardiovasc Surg
(1995) - et al.
Second malignant tumors in head and neck squamous cell carcinoma: the overshadowing threat for patients with early stage disease
Int J Radiat Oncol Biol Phys
(1989) - et al.
Bronchoscopic treatment of lung tumors
Lung Cancer
(1994) - et al.
Benign tumors of the tracheobronchial tree: endoscopic characteristics and role of laser resection
Chest
(1995) - et al.
Endoscopic treatment of malignant airway obstructions in 2,008 patients
Chest
(1996) - et al.
Fiberoptic bronchoscopic cryotherapy in the management of tracheobronchial obstruction
Chest
(1996) - et al.
Photodynamic therapy for early stage squamous cell carcinoma of the lung
Mayo Clin Proc
(1997) - et al.
Application of argon beam coagulation in urological surgery
J Urol
(1992) - et al.
Histologic characteristics of laparoscopic argon beam coagulation
J Am Assoc Gynecol Laparosc
(1998) - et al.
Role of bronchoscopy in massive hemoptysis
Principles for safety in application of neodymium-YAG laser in bronchology
Chest
Pathogenesis of systemic air embolism during bronchoscopic Nd: YAG laser operations
Ann Thorac Surg
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Severe hemoptysis in the onco-hematology patient
2024, Revue des Maladies RespiratoiresInterventional bronchoscopic treatment of lung cancer
2022, Laparoscopic, Endoscopic, and Robotic SurgeryEvaluation and Treatment of Massive Hemoptysis
2022, Surgical Clinics of North AmericaInterventional Pulmonology: A Brave New World
2020, Thoracic Surgery ClinicsCitation Excerpt :The risks related to APC are similar to those of laser photoresection; Laser therapy has also been shown to be effective in treating endobronchial disease, negating the need for invasive surgery.62,63 Small cases series have shown that APC is safe and effective in treating obstructive airway lesions, both malignant and benign.64–66 It also has been shown to provide benefit in conjunction with chemotherapy in treatment of tuberculosis with evidence of airway lesions.67
Managing Massive Hemoptysis
2020, Chest
Supported by the Mary L.E. McConnell Fund for Lung Research.