Argon plasma coagulation versus cryotherapy in alleviation of endobronchial obstruction via fiberoptic bronchoscope

Abstract

Central airway obstruction from malignant or benign endobronchial tumor can result in respiratory failure. Therapeutic bronchoscopy offers effective method in alleviating dyspnea, controlling hemoptysis and improving quality of life. Aim of the work: The aim of our study was to assess safety and efficacy of Argon plasma coagulation (APC) versus Cryotherapy in treatment of endobronchial obstruction. Patients and methods: This study was conducted at Chest Medicine Department, Mansoura University Hospital. This study included 20 patients with central airway obstruction (15 male and 5 female). They were divided into two groups. Group A treated with APC in addition to chemotherapy in case of malignant airways obstruction. Group B treated with cryotherapy besides chemotherapy in malignant patients. Clinical, radiological, bronchoscopic and functional data were evaluated before and after therapy. Results: There was significant improvement in dyspnea, hemoptysis and cough scores in both groups after therapy when compared to pre-treatment state. Spirometric parameters were improved in both groups. Radiological improvement occurred in 6 out of 10 patients in group A, in 4 out of 10 patients in group B. As regards the complications of the procedures, in group A: bleeding in one case, bronchospasm in one patient and pneumomediastinum in one patient. While in group B: 2 patients were complicated with bleeding, one patient with bronchospasm and one patient with respiratory failure. Conclusion: Both APC and cryotherapy were equally safe and effective methods for treating patients with endobronchial obstruction.

Keywords

• Argon plasma coagulation
• Cryotherapy
• Lung cancer