Endobronkhial'naya khirurgiya i fotodinamicheskaya terapiya pri zlokachestvennykh opukholyakh trakhei i bronkhov

The authors present their data on endobronchial treatment of 374 patients with malignant stenotic tumors of the trachea and bronchi (n = 150; 187 tumors), central lung cancer (CLC) (n = 119; 162 tumors), benign tumors (n = 47), and scarring stenosis (n = 58). A complex of diagnostic studies was developed, which comprised video-assisted high-resolution endoscopy, fluorescence and NBI bronchoscopy, endosonography, spiral computed tomography, and a morphological study. Indications for various endoscopic treatment options were defined. The basic techniques for tumor removal were electrocoagulation, Nd:YAG-laser thermodestruction (1984-1994), photodynamic therapy, and argon-plasma coagulation (1992-2008). In patients with stenotic tumors, complete or partial luminal recovery could be achieved in 96% of cases just after endoscopic treatment. Endoscopic treatment as a preparatory stage was performed in 24 (16%) patients before open surgery and in 81 (54%) patients prior to radiotherapy. In CLC, complete tumor regression was achieved in 89% and in 100% when tumors sized under 1 cm along the plane. A follow-up lasted as long as 8 years. A recurrence was diagnosed in 175 of cases; metachronic CLC was found in 21%. The developed endoscopic treatment options can be occasionally regarded as the only possible treatment modality or as an alternative to surgical treatment.

stenotic tumors of trachea and bronchi, early central lung cancer, endoscopic treatments