The Efficacy And Side Effects Of Bronchoscopic Interventional Therapy For Benign Airway Stenosis: A Retrospective Study

Objective The research was to provide a retrospective study of therapies against benign central airway stenosis,and evaluate clinical efficacy of interventional therapy and alternative ways of interventional therapy on patients underwent interventional therapy in the Endoscopy Center of Henan Provincial People’s Hospital.Methods We retrospective collected dates from 100 patients underwent interventional therapy in the Endoscopy Center of Henan Provincial People’s Hospital from January 2013 to December 2015.General information,symptoms,causes of strictures,CT images before and after treatment,methods of interventional therapy,and complications was collected.Treatment effect was evaluated with symptoms,CT,m MRC and clinical efficacy.Results1 Demographic characteristics of patients is 51 male cases,49 female cases;the ratio of male to female was 1.04:1.The patients were aged from 14-87,(mean 41.8±16.9)years old.2 Causes of stenosis: 30 PITS and 20 PTTS,21 tuberculosis,17 benign tumor,2trauma,2 ectopic thyroid gland,2 ossification tracheal bronchus,1 recurrent chondritis,1tracheobronchial amyloid degeneration,and 4 the other unknown reason.3 Gender profile in airway stenosis:male in 33 cases caused by tracheotomy and intubation,female in 17cases;Airway stenosis caused by tuberculosis: male in 4 cases,female in 17 cases;Benign tumor: male in 8 cases,female in 9 cases.4 Location of stenosis: trachea in 59 cases,right principal bronchus in 11 cases,9cases of left principal bronchus,1 cases of trachea and right principal bronchus,1 cases of trachea and left principal bronchus,1 cases of trachea and left and right principal bronchus,bronchus intermedius in 6 cases,right upper lobe in 3 cases,3 cases of right middle lobe and right lower lobe in 2 cases,left upper lobe in 4 cases.5 Application of interventional modalities for benign airway stenosis: 100 patients were treated with totally 387 person-times of interventional therapy.Every patient was applied at least 1 time and at most 27 times of therapy(average 3.87).In total,607 interventional modalities were applied.1.57 modalities were applied per therapy.Balloon dilatation for 65 times,cryotherapy for 313 times,electrocautery for 145 times,argon plasma coagulation for 73 times,stent implantation for 11 times.6 The median of average treatment interval of benign stenosis was 11 days,and the quartile was(4.5,20)days.The median of frequency for treatment was 2 times.And the quartile was(1,4)times.The course of treatment was 33 days.And the quartile was(9,70)times.7 m MRC:2.36±1.177 before treatment,0.80±0.682 after treatment(t=18.468,P<0.01).Thoracic CT images were available in 18 patients of PITS and PTTS,and the airway diameter before and after treatment were 6(5,8)mm and 10(9,13)mm respectively(Z=-5.233,P<0.01).The effective rate of interventional therapy was 94%in the PITS and PTTS;76% in the Tuberculosis sub group;and 94% in the benign tumor group.8 Methods of interventional therapy differ for the causes of airway stenosis.The most often used methods were cryotherapy in PITS and PTTS,followed by electrocautery,argon plasma coagulation,balloon dilatation respectively;While in tuberculosis stenosis the most widely used methods were cryotherapy,followed by balloon dilatation,electrocautery respectively;benign tumor stenosis is the most used methods were electrocautery,followed by argon plasma coagulation,cryotherapy respectively,There was significant in the ratio of modality constitution among the three groups and between each two groups(P<0.01).Conclusions1 The PITS and PTTS are the primary cause of benign airway stenosis,followed by tuberculosis and benign tumor and the strictures primarily located in central airway.2 Cryotherapy,electrocautery combined with argon plasma coagulation,balloon dilatation are primary ablative modalities for PITS and PTTS;Cryotherapy and balloon dilatation combined with electrocautery or argon plasma coagulation are the primary choice for tuberculosis;Electrocautery,argon plasma coagulation and cryotherapy are primary ablative modalities for benign tumor.3 Interventional ablative techniques offer a safe and effective modality for the treatment of benign airway stenosis,which can relieve symptoms in patients with airway stenosis,and improve their quality of life.