Fiberoptic Bronchoscopic Cytotherapy in the Management of Obstructing Endobronchial Carcinoma

Patients with obstructing Endobronchial carcinoma may be presented with dyspnea, hemoptysis, cough or life threatening respiratory failure. Bronchoscopic cryotherapy representing a palliative safe and effective method to relieve symptoms and improve quality of life. Aim of the work was to assess the possible benefits and safety of fiberoptic bronchoscopic cryotherapy as a method of management of malignant endobronchial obstruction hoping to improve quality of life of these patients. This study was conducted on 28 patients diagnosed previously as having malignant Endobronchial obstruction. The study was done using flexible bronchoscopic cryotherapy with flexible cryoprobe. The size of the endobronchial tumors and symptoms were evaluated 4 and 8 weeks after bronchoscopic Cytotherapy. Eight weeks after flexible bronchoscopic Cytotherapy, there was a significant improvement in clinical symptoms, radiology; pulmonary function tests (PFTs), arterial blood gases (ABGs), 6 minutes' walk test (6 MWT) and quality of life. With less incidence of complications, which was reported in 6/28 (21.4%) cases in the form of infection, fever and hemorrhage. Cytotherapy is safe and highly effective method of endobronchial recanalization in treatment of malignant endobronchial obstruction. It improves symptoms, PFTs, ABGs parameters, and quality of life in a significant pattern, also it is easy, of low cost, and less complications. Multiple sessions may be needed in cases with complete endobronchial obstruction.