Radiofrequency resection of bronchial tumours in combination with cryotherapy: evaluation of a new technique.

BACKGROUND: A number of treatments, including Nd-YAG laser therapy, brachytherapy, cryotherapy, electrocautery, and photodynamic therapy, can re-open the obstructed bronchial lumen in patients with inoperable obstructive bronchial tumours. None of these is considered to be a "gold standard". METHODS: The results of a retrospective study of 98 patients treated by radiofrequency tissue ablation and subsequent cryotherapy between January 1994 and June 1995 are reported. The patients were divided in two groups according to whether they were treated either after (group 1, n = 50) or before (group 2, n = 48) radiotherapy and/or chemotherapy. Bronchoscopic follow up was performed. The intervention was considered successful if the lumen was opened by > 80% and partially successful if it was opened by > 50%. RESULTS: In group 1 treatment was successful in 60%, partially successful in 32%, and unsuccessful in 8%. The median survival time was five months from the time of bronchoscopic surgery. In group 2 treatment was successful in 66%, partially successful in 21.5%, and unsuccessful in 12.5%, with a median survival time of 14 months from the time of bronchoscopic treatment. Forty patients (24 in group 1 and 16 in group 2) received a Dumon stent. CONCLUSIONS: Radiofrequency bronchoscopic surgery with cryotherapy appears to be a useful technique in the treatment of tracheobronchial obstruction.

Cryosurgery in bronchoscopic treatment of tracheobronchial stenosis. Indications, limits, personal experience.

Cryosurgery is one of the techniques available for bronchoscopic treatment of malignant and nonmalignant tracheobronchial stenosis; other techniques are electrosurgery, laser therapy, and endobronchial brachytherapy. Our experience began in 1976 and includes more than 300 patients treated with bronchoscopic cryosurgery either for malignant (the majority) or for nonmalignant tracheobronchial lesions. This study was performed on 234 patients treated in the years 1979 to 1988 subdivided as follows: 183 malignant tumors, 44 benign tumors, and 7 tumors of uncertain prognosis (adeno). The study demonstrated satisfying results in both (palliative in the first case, almost radical in the second one). The aim of our work was to report our personal data and to compare advantages and limits of this technique to others.

[Epidemiologic study of 1665 cases of bronchogenic neoplasms collected at the S. Luigi Gonzaga Hospital between 1973 and 1979]. / Studio epidemiologico su 1665 casi de neoplasie broncogene raccolte all' Ospedale "S. Luigi Gonzaga" fra il 1973 e il 1979.

Data regarding 1,665 cases of benign and malignant lung cancers are examined and frequency behaviour analysed by histological type, sex, age groups and site of onset. Results are compared with other reported data and it is concluded that there is a considerable increase in dyskaryokinesis in both sexes, especially females (particularly epidermoid forms), and that there is a shift in maximum incidence towards more advanced age groups. No variation was seen, however, with respect to the frequency of bronchial tree localisation.

[Endobronchopulmonary therapy with a permanent trans-crico-thyroid probe]. / Terapia endobroncopolomonare con sonda permanente trans-crico-tiroidea.

The possibilities of treating chronic bronchopneumopathies of various nature by means of permanent endobronchial transcricothyroid probe are examined with reference to 6 cases representing patients under treatment at the time this paper was being prepared (2 cases of chronic pulmonary TB, 2 of suppurating bronchiectasis, 1 of middle lobe syndrome and 1 of tracheal carcinoma). The series examined confirms the usefulness of this type of treatment as a back-up to traditional medical treatment where this alone failed to achieve the necessary results. Stress is laid on the good tolerance of the TCT probe presented by all patients, including a five-year-old boy.