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Objective To investigate the incidence and bacterial etiology of stent associated respiratory tract infec-tion (SARTI) caused by two types of airway stents.Methods Silicone and coated metal airway stent were placed into patients with central airway stenosis caused by varied pathologies. The incidence of stent related respiratory tract infection,bacteria etiology of SARTI and improved dyspnea score were compared between two groups receiving different airway stent.Results 1)Totally 171 patients received airway stents, and among them, 39 patients (22.81%) developed SARTI.2)The incidence of SARTI in metal stent group and silicone stent group was 29.21% (26/89) vs.15.85% (13/82),P<0.05;3)Bacterial spectrum of SARTI was different in metal and silicone stent groups:staphylococcus aureus was 38.46% vs. 69.23%,respectively;candida albicans was 23.08% vs. 0%,re-spectively;Singular proteus was 7.26% vs.0%,respectively;4)The narrowed lumen was improved from 74.27%± 7.13% to 17.64%±6.22%in the metal stent group,while the data was improved from 74.94%±9.18% to 12.68%± 8.32% in the silicone stent group (P<0.01). Accordingly, the dyspnea symptomscore was improvedfrom 2.85 ± 0.89 to 0.85±0.68 in metal stent group,and from 2.88±0.91 to 0±0.61 in the silicone stent group (P<0.05). Conclusions Compared with metal airway stents,silicone stents have a lower incidence of SARTI,which mightbe due to the projections in the silicon stent surface and wider expanded in the bronchial stenosis.
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<p><b>OBJECTIVE</b>Primary airway neoplasms are extremely rare in the pediatric age group. This paper reports 4 children with primary airway neoplasms to explore the clinical manifestations, safety and efficacy of bronchoscopic interventions.</p><p><b>METHOD</b>The data of pathology, photographic documentation and imaging studies were analyzed.</p><p><b>RESULT</b>Of the 4 reported lesions, 2 were characterized by low-grade (2 with mucoepidermoid carcinoma) and 2 by high grade malignant (spindle cell carcinoma and malignant lymphoma). Onset of clinical manifestations occurred at the ages of 7 months to 7 years. All of them were initially misdiagnosed as bronchitis, asthma or atelectasis. The lesions located in trachea in 2 patients, in left bronchus of 1 patient and in right middle bronchus of 1 case. Atelectases occurred in bilateral bronchus where the lesions obstructed almost the entire lumen at the time of diagnosis. The diagnosis of airway masses depends upon maintaining a high index of suspicion, complemented by imaging and timely diagnostic endoscopy. The lesions were completely removed in 3/4 patients except 1 died during bronchoscopic procedures.</p><p><b>CONCLUSION</b>The children with malignant airway neoplasms were presented with cough and wheezing without specific manifestations. Bronchoscopic interventions were effective in the treatment of non-operative cases. General anesthesia is strongly recommended for interventional bronchoscopy.</p>
Subject(s)
Child , Child, Preschool , Female , Humans , Male , Bronchoscopy , Retrospective Studies , Tracheal Neoplasms , Diagnosis , TherapeuticsABSTRACT
Objective: To explore an ideal method and evaluate its clinical outcome in treating bronchostenosis induced by esophagus cancer. Methods: All cases were given argon plasma coagulation therapy to widen their trachea and shrink the focus area in terms of the invasion site and severity of trachea. Then some of them were placed with membrane-covered trachea brackets or given photodynamic therapy. Finally all the patients received bronchial artery embolizing chemotherapy to enhance the therapeutic efficacy. Results: Among the 23 cases treated with argon plasma coagulation (APC) therapy, 4 patients who did not receive any other treatment died within 58 days. The six patients who were placed trachea brackets only lived a period of 98 days on average. Seven patients who were placed trachea brackets and given bronchial artery embolizing chemotherapy lived a period of 166 days on average. Among the rest 6 cases who were cured with photodynamic therapy plus bronchial artery embolizing chemotherapy, 2 suffered from trachea-esophagus fistula 1-2 month later after leaving hospital and membrane-covered trachea brackets had to be rearranged. One died of severe emptysis 126 d later. The patients were followed up until November 30, 2007. The survival period in 2 cases was over 180 d, in 2 cases over 220 days, and in 1 case over 240 d. The mean survival time was 198 d during follow-up period. Conclusion: The combined multifold sequential therapy guided by endoscope is an ideal method to cure bronchostenosis induced by esophagus cancer. It is worthy of further studying and publicizing.
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Objective To investigate the imaging manifestations of lung neoplasms in pre- and post- treatment with CT-guided Argon-Helium cryoablation.Methods All the lung neoplasms in 96 patients have been treated with CT-guided percutaneous Argon-Helium targeted cryoablation.All patients have pre- and post-treatment CT scanning in measurement of lesion size and CT value.The CT scanning has been rerpeated afterl,3,6,12 months of treatment.Results Among total 96 cases,there are 82 cases of lung cancer and 14 cases of metastasis with 110 lesions(89 cases with single lesion,7 cases with multiple lesions).The Ar-He cryoablation has been given 103 times in total.The size of each lesion ranged from 1.2 cm to 15.0 cm in diameter with mean value of(4.0?2.5)cm,including 12 lesions less than 2 cm,51 lesions between 2— 4 cm,24 lesions between 4—6 cm,23 lesions over 6 cm.There are 25 patients whose lesions covered by iceball with 1 cm of overloaping it's margin.There are 63 lesions with diameter less than 4 cm gained 100% ablation rate,24 lesions with 4—6 cm diameter gained 95.8% ablation rate,and 23 lesions with over 6 cm diameter gained 69.6% ablation rate.The post-treatment CT show a progressively enlarged round,low density refrigerant area which clearly demarked with non- refrigerant area.The center of each refrigerant area has negative CT value,the mean decreased CT value of lesion instantly after the treatment are about 30— 50 HU with P