BACKGROUND AND OBJECTIVE: Microdebrider bronchoscopy is a relatively new modality for the management of central airway obstruction (CAO) of both benign and malignant origin. Our objective was to describe our experience with this technique, with special attention to its safety and effectiveness. METHODS: We retrospectively reviewed cases of therapeutic bronchoscopies using microdebrider for CAO from two institutions (M.D. Anderson Cancer Center and Michael E. Debakey VA Medical Center, Houston) from August 2008 through February 2012. RESULTS: We identified 51 cases. Malignant CAO was detected in 36 cases (71%): non-small-cell lung cancer (n = 22), melanoma (n = 3), small-cell-lung cancer (n = 2), thyroid cancer (n = 2), esophageal carcinoma (n = 2), breast cancer (n = 2), and others (n = 3). Benign diseases included: papillomas (n = 8), granulation tissue (n = 3), and others (n = 4). Obstruction was purely endoluminal in 32 cases (63%). Pre-treatment obstruction was severe in 25 cases (49%), moderate in 20 cases (39%) and mild in 6 (12%). Lesions were located in the trachea (n = 23), main stem bronchi (n = 25), and bronchus intermedius (n = 8), with some patients having more than one lesion. After tumor debulking with microdebrider, the residual airway obstruction was insignificant (n = 27 cases; 53%), mild (n = 23 cases; 45%), and moderate (n = 1; 2%). No major complications were encountered, only 2 patients had mild adverse events: one case of pneumomediastinum, and one self-expandable stent damage requiring its removal. Two patients (4%) died within 30 days of causes unrelated to the procedure or the CAO. CONCLUSIONS: Microdebrider bronchoscopy is a potentially safe and effective way to manage central airway obstruction of both malignant and benign origin.
BACKGROUND AND OBJECTIVE: Microdebrider bronchoscopy is a relatively new modality for the management of central airway obstruction (CAO) of both benign and malignant origin. Our objective was to describe our experience with this technique, with special attention to its safety and effectiveness. METHODS: We retrospectively reviewed cases of therapeutic bronchoscopies using microdebrider for CAO from two institutions (M.D. Anderson Cancer Center and Michael E. Debakey VA Medical Center, Houston) from August 2008 through February 2012. RESULTS: We identified 51 cases. Malignant CAO was detected in 36 cases (71%): non-small-cell lung cancer (n = 22), melanoma (n = 3), small-cell-lung cancer (n = 2), thyroid cancer (n = 2), esophageal carcinoma (n = 2), breast cancer (n = 2), and others (n = 3). Benign diseases included: papillomas (n = 8), granulation tissue (n = 3), and others (n = 4). Obstruction was purely endoluminal in 32 cases (63%). Pre-treatment obstruction was severe in 25 cases (49%), moderate in 20 cases (39%) and mild in 6 (12%). Lesions were located in the trachea (n = 23), main stem bronchi (n = 25), and bronchus intermedius (n = 8), with some patients having more than one lesion. After tumor debulking with microdebrider, the residual airway obstruction was insignificant (n = 27 cases; 53%), mild (n = 23 cases; 45%), and moderate (n = 1; 2%). No major complications were encountered, only 2 patients had mild adverse events: one case of pneumomediastinum, and one self-expandable stent damage requiring its removal. Two patients (4%) died within 30 days of causes unrelated to the procedure or the CAO. CONCLUSIONS: Microdebrider bronchoscopy is a potentially safe and effective way to manage central airway obstruction of both malignant and benign origin.
Authors: David E Ost; Armin Ernst; Horiana B Grosu; Xiudong Lei; Javier Diaz-Mendoza; Mark Slade; Thomas R Gildea; Michael Machuzak; Carlos A Jimenez; Jennifer Toth; Kevin L Kovitz; Cynthia Ray; Sara Greenhill; Roberto F Casal; Francisco A Almeida; Momen Wahidi; George A Eapen; Lonny B Yarmus; Rodolfo C Morice; Sadia Benzaquen; Alain Tremblay; Michael Simoff Journal: Chest Date: 2015-08 Impact factor: 9.410
Authors: Joshua B Gafford; Scott Webster; Neal Dillon; Evan Blum; Richard Hendrick; Fabien Maldonado; Erin A Gillaspie; Otis B Rickman; S Duke Herrell; Robert J Webster Journal: Ann Biomed Eng Date: 2019-07-24 Impact factor: 3.934
Authors: David E Ost; Armin Ernst; Horiana B Grosu; Xiudong Lei; Javier Diaz-Mendoza; Mark Slade; Thomas R Gildea; Michael S Machuzak; Carlos A Jimenez; Jennifer Toth; Kevin L Kovitz; Cynthia Ray; Sara Greenhill; Roberto F Casal; Francisco A Almeida; Momen M Wahidi; George A Eapen; David Feller-Kopman; Rodolfo C Morice; Sadia Benzaquen; Alain Tremblay; Michael Simoff Journal: Chest Date: 2015-05 Impact factor: 9.410