Interventional therapeutic bronchoscopies. Our experience

Introduction The incorporation of techniques such as laser, electrocautery, cryotherapy and endobronchial stens has favoured the development of „Interventional Pneumology“. thus avoiding more invasive procedures.

Material and method This is a descriptive, retrospective study in which 41 interventional bronchoscopies have been performed through: rigid bronchoscope in 26 cases, laryngeal mask in 8, tracheostomy cannula in 4 and orotracheal tube in 3. The data collected were: sex, age, basic pathology, type of technique performed, survival after the intervention and cause of death.

Results Between January 2016-November 2017, 41 interventional therapeutic bronchoscopies were performed (29 male/12 women; mean age 59), with a total of 62 procedures. Indications: malignant stenosis 39% (16/41), benign stenosis of the airway 19.5% (8/41), endobronchial lesion 12.1% (5/41), idiopathic stenosis of the airway 12.1% (5/41), 4 cases of tracheoesophageal fistula, 2 extractions of foreign body and 1 bronchopleural fistula. Within the benign stenoses, the secondary to orotracheal intubation was the most frequent 37.5% (3/8). Among the malignant stenoses, 87.5% were due to lung carcinoma (14/16), 2 cases being extrinsic compression. Of the resected endobronchial lesions, 60% (3/5) resulted carcinoid tumors. The most used technique was placement of stent 27.4% (17/62): 13 metallic and 4 silicone; followed by balloon dilation 25.8% (16/62); 24.1% electrocautery resection (15/62); mechanical resection 16.1% (10/62); in 3 cases a laser was used and in 1 case a unidirectional endobronchial valve was placed. Only in one of the cases was it possible to implant a stent. The most used combined procedure has been balloon dilation followed by prosthesis implantation. Complications occurred in 9 cases. 16 deaths occurred (all due to progression of the basic neoplastic process, average survival of 3 months); 21 are still alive and of 4 of them we do not have information.

Conclusions■

• Interventional therapeutic bronchoscopy is a safe and effective procedure in the management of airway lesions.

• The complication rate in our experience is low.

• In selected cases of malignant nature, can improve significantly the quality of life of patients.

• No increase in mortality has been observed in relation to the therapeutic procedure.