Küçük hücreli akciğer kanserinde lazer rezeksiyonu ve silikon stent implantasyonu

Giriş: Terapötik bronkoskopi hava yolu açıklığının sağlanması için acil müdahale gereken akciğer kanseri hastalarında solunum patenimi normale döndürür ve yaşam süresini artırır. Materyal ve Metod: Küçük hücreli akciğer kanseri (KHAK) olan 4 olguda Nd- YAP Laser ile rezeksiyon ve silikon stent implantasyonu uygulandı. Vena Cava Superior Sendromu ve ileri derecede solunum sıkıntısı ile başvuran üç olguda endolüminal tümör ve eksternal kompresyona bağlı trakeobronşiyal obliterasyon mevcuttu. Bu olgularda 2 seansda endolüminal tümör Nd-YAP laser ile rezeke edildikten sonra Dumon Y-silikon stent yerleştirildi. Eksternal kompresyona bağlı trakeobronşiyal obliterasyon sonucu ağır hipoksemi ve hiperkapni ile başvuran diğer hastada rigid bronkoskop ve dilatasyon balonu uygulandıktan sonra Dumon Y-silikon stent ile hava yolu açıklığı sağlandı. Sonuç: Primer tedavi modaliteleri kemoterapi ve radyoterapi olduğu halde yaşamı tehdit eden trakeobronşiyal obstrüksiyonun olduğu KHAK hastalarında terapötik bronkoskopik yöntemler ilk sırada uygulanmalıdır.

Laser resection and silicone stent implantation for the small cell lung cancer

Background: Therapeutic bronchoscopy is associated with increased survival rates among patients with lung cancer who required emergency treatment to restore airway patency. Methods: Four patients with small cell lung cancer (SCLC) underwent bronchoscopic laser resection and silicon stent insertion. In three cases with Vena Cava Superior Syndrome and severe dyspnea the symptoms were due to tracheobronchial obliteration which caused by both external compression and endoluminal tumoral invasion. The endoluminal part of the tumor was resected with laser in two sessions and Dumon Y-silicone stent was inserted. In the other patient who had severe hypoxemia and hypercapnia; nearly totally tracheobronchial obliteration by external compression were present. Dumon Y-silicon stent was implanted after dilatation with rigid bronchoscopy and dilatation ballon. Conclusions: Although primary treatment modalities are chemotherapy and radiotherapy in SCLC, patients with life threatening total tracheobronchial obliteration should be treated with therapeutic bronchoscopy as first step intervention.

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