Choice of bronchoscopic intervention working channel for benign central airway stenosis
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Choice of bronchoscopic intervention working channel for benign central airway stenosis Hui Chen1,2 · Jie Zhang1 · Xiaojian Qiu1 · Juan Wang1 · Yinghua Pei1 · Yuling Wang1 · Ting Wang1 Received: 23 March 2019 / Accepted: 7 October 2020 © Società Italiana di Medicina Interna (SIMI) 2020
Abstract The purpose of this study is to report our experiences over 12 years with bronchoscopic interventions in patients with benign central airway stenosis using three types of working channels (rigid bronchoscope, laryngeal mask, and endotracheal intubation), with a focus on their related advantages, disadvantages, and postoperative complications. We analyzed the clinical data from 273 patients with benign central airway stenosis who underwent a bronchoscopic intervention. The Wilcoxon rank-sum test was used to analyze the immediate results after the first bronchoscopic intervention, and the Chi-square test was used to analyze the correlation between glottic edema and operation time. The 273 patients underwent a total of 479 bronchoscopic interventions, with satisfactory results. The immediate effective rates of the first bronchoscopic intervention by rigid bronchoscope, laryngeal mask, and endotracheal intubation were 91.4%, 91.3%, and 85.2%, respectively. Postoperative complications related to the working channels included hoarseness, glottic edema, pharyngalgia, paresthesia pharynges, cough, and tooth loss. Glottic edema was the most serious complication, and it occurred in 37.7% (23/61) of the rigid bronchoscope group and 9.8% (32/326) in the laryngeal mask group. And the incidence rate was significantly correlated with the operation time (P 95%. Dynamic electrocardiogram, non-invasive blood pressure, and peripheral oxygen saturation were monitored throughout the treatment process.
Therapeutic procedures The 273 patients with benign central airway stenosis underwent a total of 479 bronchoscopic interventions, and all operations were completed through rigid bronchoscope, laryngeal mask, or endotracheal intubation. The
Internal and Emergency Medicine
therapeutic methods were selected based on the specific disease as follows: Larger granulation tissue and tumors in the tracheobronchial tree were removed by high frequency electric knife or snare (ERBE, Tubingen, Germany), and Holmium laser (VersaPulse PowerSuite 100 W, Lumenis, USA). The power of the electric current was set at 60 W. The power and pulse frequency of the laser were set at 8 W and 10 Hz, respectively. Smaller granulation tissue was removed directly with biopsy forceps. For scar airway stenosis, we used an electronic knife to release the scar tissue, then a balloon (Boston Scientific Corporation, Marlborough, USA) to expand the stenosis segment, and finally cryotherapy (Kooland, Beijing, China) was applied to reduce the restenosis of scar. A combination of different techniques was used when required. If airway stenosis could not be managed by the above methods, silicone airway stents or T-tubes were placed using a rigid bronchoscope (Karl Sto
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