Abstract
BACKGROUND AND OBJECTIVE: Treatment of critical airway stenoses remains a formidable challenge to surgeons and anesthesiologists. Suffocate is a leading cause of death if the patients with airway diseases were not treated properly. The purpose of this study is to explore the feasibility, safety and efficiency using video-assisted rigid bronchoscopes (VARB) in the treatment of central airway stenoses. METHODS: From August 27, 2007 to September 30, 2010, 194 patients (140 men and 54 women, mean age 57.5±1.3 years) with airway stenoses (145 with malignant and 49 with benign stenoses) were retrospectively reviewed underwent VARB treatment in our hospital. All the procedures were carried out under general anesthesia with high frequency jet ventilation. After the VARB was placed in the main trachea through the mouth, electric bronchoscope was combined to examine the lesions. Various methods for controlling the airway have been established to solve this problem, such as the electric loop, cryoprobe or argon plasma coagulation (APC) and stents. RESULTS: T325 procedures were accomplished in all the 194 cases. Every patients received 1.6 procedures of VARB. VARB occupied 21.3% (325/1,525) in all bronchoscopic procedures. Among the patients, there were 76 cases with primary airway tumor and 69 with secondary malignant tumor, 49 with benign airway stenoses. Karnofsky performance status (KPS) and short breathless index were obviously improved after the first treatment of VARB. Improvement of bronchial stenoses was superior to that of tracheal stenoses. The effect of electasis treatment is better in obstruction of main bronchus than that of segment bronchus. 26 airway stents were removed and 13 stents were successfully placed under VARB. CONCLUSIONS: VARB can be applied safely and effectively for the management of tracheobronchial stenoses. Quality of life was improved after the treatment of VARB.