Therapeutic Bronchoscopy In Patients with Symptomatic Airway Lesions Argon Plasma Coagulation / Electrocautery

Endobronchial treatments are widely used for treating airway obstruction with the goal of relieving large airway obstructions caused by malignant or benign lesions. However, they may be curative in patients with benign conditions. We aimed to evaluate the usefulness of endobronchial argon plasma coagulation (APC) and electrocautery (EC) for treating patients with airway obstruction. Methods: We conducted a retrospective study in the bronchoscopy unit of a training and research hospital. Endobronchial treatment was carried out in 56 evaluable patients between 2007 and 2012. We used a rigid bronchoscope in 18 patients and flexible bronchoscope in 38 patients. General anaesthesia was administered to 32% (18 patients) patients. Bronchogenic carcinoma was seen in 43 patients, metastatic bronchial tumours in 1, and benign airway disease in 12. Obstruction sites were the trachea in 15 patients, main stem bronchi in 28 and lobar bronchi in 5. Eight patients had obstruction at multiple sites. Mean degree of obstruction was 84%. Immediately after the treatment, the mean degree of obstruction was 44%. Mean overall decrease in degree of obstruction was 39%. Post-tretament improvement of dyspnoea was excellent in 31 cases (55%) and moderate in 23 cases (41%); dyspnoea improvement was absent in 2 cases. Three complications (2 cases of respiratory insufficiency, 1 of mediastinal emphysema) were directly related to the endobronchial treatment. Conclusion: APC and EC are effective, rapid and repeatable techniques for treating endoluminal airway lesions and can effectively decrease dyspnoea.