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Interventional bronchoscopic techniques for management of central airway obstruction and hemoptysis in patients with lung cancer

Interventional bronchoscopic techniques for management of central airway obstruction and hemoptysis in patients with lung cancer
Tumor location: Endoluminal Extrinsic Mixed
Clinical problem Airway obstruction Hemoptysis Airway obstruction Airway obstruction Hemoptysis
Laser
  • Nd:YAG
+ + + +
  • Nd:YAP
+ + + +
  • Ho:YAG
+ + + +
  • KTP
  • CO2
Electrocautery + + + +
Argon plasma coagulation + + + +
Cryotherapy (contact) + + + +
Photodynamic therapy ± ±
Brachytherapy + + +
Mechanical debridement + + + +
Rigid bronchoscopy + + + + +
Balloon dilatation ± + ±
Stenting + + +
Interventional techniques for management of airway obstruction or hemoptysis in patients with lung cancer. Airway obstruction may manifest as dyspnea, cough, wheeze, atelectasis, or collapse and can be as extreme as respiratory failure. In both airway obstruction and hemoptysis, airway security should be a priority and may require an invasive artificial airway or rigid bronchoscopy. This table reflects only airway obstruction due to malignant causes. Interventional bronchoscopy requires a multidisciplinary team and is based on the availability of the technology and the appropriate experience and skill of the operator. These procedures should only be performed at centers with experience.
+: indicated; –: not indicated; Nd:YAG: neodymium-doped yttrium-aluminum-garnet; Nd:YAP: neodymium-doped yttrium-aluminum-perovskite; Ho:YAG: holmium yttrium-aluminum-garnet; KTP: potassium-titanyl-phosphate; ±: equivocal; CO2: carbon dioxide.
From: Simoff MJ, Lally B, Slade MG, et al. Symptom management in patients with lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2013; 143:e455S. Copyright © 2013. Reproduced with permission from the American College of Chest Physicians.
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