Prognostic factors for bronchoscopic electrocautery and/or argon plasma coagulation in patients with localized central airway obstruction

this study was conducted in the Chest Departments (Bronchoscopy Units) of Ain-Shams and Zagazig University Hospitals during the period from May 2008 to March 2011. Twenty nine patients, 21 males and 8 females, their age ranged from 20 to 67 years with a mean age of 50.45 ± 12.14 were recruited in the study. All the included patients had a diagnosed tracheal, bronchial or tracheobronchial obstruction, categorized into malignant and non-malignant groups with different pathological varieties. Patients completed their chemotherapy and/or radiotherapy or did not receive it at all and their lesions had contraindication to surgery either absolute or relative.Patients were selected for therapeutic bronchoscopy according to predefined criteria. Collected data included patients’ demographics, presenting symptoms, signs and co-morbidities. Evaluation of dyspnea, cough and hemoptysis scales were done before the interventional bronchoscopy and one day after the last session. Routine laboratory investigations were performed to studied patients (Liver and Kidney functions, complete blood picture, bleeding and coagulation profile). Plain Chest X- ray, Computed spiral tomography and Virtual bronchoscopy was carried out for all patients before the intervention. Evaluation of performance scale and quality of life status before the procedure and one day after the last session were estimated. Flow – volume loop ventilatory function testing and Arterial blood gases analysis were done before the interventional bronchoscopy and one day after the last session. Diagnostic flexible bronchoscopy was done for patients with suspected central airway obstruction for confirmation of its presence and locates its site and size. Interventional bronchoscopic Procedures were performed under general anesthesia. The flexible scope was either passed via an endotracheal tube or through the rigid bronchoscope. Follow up bronchoscopy was routinely done one week after each interventional session for evaluation of the changes in the size of the lesion, moreover, removal of the devitalized tissue and debris were the objectives of follow up bronchoscopy in these cases.