PREOPERATIVE ENDOBRONCHIAL SANITATION AS PREPARATION FOR THORACIC INTERVENTIONS
Abstract
The aim – to study the effectiveness of endoscopic photodynamic therapy as a preoperative preparation of the tracheobronchial tree in patients with lung cancer.
Materials and methods. The study included 181 patients with II-III stage of lung’s cancer. Diagnose of lung’s cancer was confirmed with a morphologically and concomitant endobronchitis. During the preoperative preparation, we used a technique developed by us introducing into the tracheobronchial tree an aqueous solution of brilliant green at concentration of 0.04 %, followed by irradiation of this solution with laser radiation with the wavelength of 0.63 μm (AFL-2 helium-neon laser) in an independent form and in combination with traditional anti-inflammatory therapy. Endoscopic endobronchial sanitation therapy was carried out by low-intensity radiation of the red part of the spectrum (λ=0.63–0.66 μm) in a pulsed mode, with a power of 12 mW.
Results. After 3–5 days of the start preoperative preparation and 1–2 sessions of endoscopic bronchosanation, the general state of patients was improved, the amount of sputum decreased and was changing from mucopurulent to mucous. To completely stop the clinical phenomena of endobronchitis, it was necessary to conduct 5-6 sessions of endoscopic photodynamic therapy according to our methodology, with the introduction of our method. In patients without pronounced clinical symptoms of concomitant chronic bronchitis, it was enough to complete only 3 sessions of bronchosanation.
Conclusion. Endoscopic photodynamic bronchosanation in the preoperative period in patients for correcting accompanying endobronchitis can significantly reduce or completely stop the clinical manifestations of endobronchitis in the shortest time and leads to a significant decrease in the number of endobronchial complications in surgical and combined treatment of lung cancer.
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Cao, C., Manganas, C., Ang, S. C., Peeceeyen, S., Yan, T. D. (2012). Video-assisted thoracic surgery versus open thoracotomy for non-small cell lung cancer: a meta-analysis of propensity score-matched patients. Interactive CardioVascular and Thoracic Surgery, 16 (3), 244–249. doi: http://doi.org/10.1093/icvts/ivs472
Pagès, P.-B., Mordant, P., Renaud, S., Brouchet, L., Thomas, P.-A., Dahan, M., Bernard, A. (2017). Sleeve lobectomy may provide better outcomes than pneumonectomy for non–small cell lung cancer. A decade in a nationwide study. The Journal of Thoracic and Cardiovascular Surgery, 153 (1), 184–195.e3. doi: http://doi.org/10.1016/j.jtcvs.2016.09.060
Maurizi, G., D’Andrilli, A., Anile, M., Ciccone, A. M., Ibrahim, M., Venuta, F., Rendina, E. A. (2013). Sleeve Lobectomy Compared with Pneumonectomy after Induction Therapy for Non–Small-Cell Lung Cancer. Journal of Thoracic Oncology, 8 (5), 637–643. doi: http://doi.org/10.1097/jto.0b013e318286d145
Ma, Q.-L., Guo, Y.-Q., Shi, B., Tian, Y.-C., Song, Z.-Y., Liu, D.-R. (2016). For non-small cell lung cancer with T3 (central) disease, sleeve lobectomy or pneumonectomy? Journal of Thoracic Disease, 8 (6), 1227–1233. doi: http://doi.org/10.21037/jtd.2016.04.60
Gonzalez, M., Litzistorf, Y., Krueger, T., Popeskou, S. G., Matzinger, O., Ris, H.-B. et. al. (2013). Impact of Induction Therapy on Airway Complications After Sleeve Lobectomy for Lung Cancer. The Annals of Thoracic Surgery, 96 (1), 247–252. doi: http://doi.org/10.1016/j.athoracsur.2013.04.009
Iijima, Y., Hirotsu, Y., Amemiya, K., Higuchi, R., Nakagomi, T., Goto, T. et. al. (2019). Endotracheal or Endobronchial Metastasis of Lung Squamous Cell Carcinoma. Journal of Bronchology & Interventional Pulmonology, 26 (4), e46–e50. doi: http://doi.org/10.1097/lbr.0000000000000595
Maurizi, G., Ciccone, A. M., Vanni, C., D’Andrilli, A., Ibrahim, M., Andreetti, C. et. al. (2018). Reimplantation of the upper lobe bronchus after lower sleeve lobectomy or bilobectomy: long-term results†. European Journal of Cardio-Thoracic Surgery, 53 (6), 1180–1185. doi: http://doi.org/10.1093/ejcts/ezx494
Blatter, J., Krueger, T., Ris, H.-B., Baeriswyl, M., Lovis, A., Zellweger, M. et. al. (2018). Complex Tracheocarinal Reconstructions Using Extrathoracic Muscle Flaps as Airway Substitutes. The Annals of Thoracic Surgery, 105 (5), 1492–1498. doi: http://doi.org/10.1016/j.athoracsur.2018.01.021
Storelli, E., Tutic, M., Kestenholz, P., Schneiter, D., Opitz, I., Hillinger, S., Weder, W. (2012). Sleeve resections with unprotected bronchial anastomoses are safe even after neoadjuvant therapy. European Journal of Cardio-Thoracic Surgery, 42 (1), 77–81. doi: http://doi.org/10.1093/ejcts/ezr291
Hong, T. H., Cho, J. H., Shin, S., Kim, H. K., Choi, Y. S., Zo, J. I. et. al. (2018). Extended sleeve lobectomy for centrally located non-small-cell lung cancer: a 20-year single-centre experience†. European Journal of Cardio-Thoracic Surgery, 54 (1), 142–148. doi: http://doi.org/10.1093/ejcts/ezy011
Hishida, T., Aokage, K., Yoshida, J., Miyoshi, T., Tsuboi, M. (2018). Extended bronchoplasty for locally advanced left lower lobe lung cancer: surgical technique and outcomes†. Interactive CardioVascular and Thoracic Surgery, 27 (4), 602–605. doi: http://doi.org/10.1093/icvts/ivy081
Vannucci, J., Matricardi, A., Potenza, R., Ragusa, M., Puma, F., Cagini, L. (2018). Lobectomy with angioplasty: which is the best technique for pulmonary artery reconstruction? Journal of Thoracic Disease, 10 (S16), S1892–S1898. doi: http://doi.org/10.21037/jtd.2018.05.174
Chen, H., Huang, L., Xu, G., Zheng, B., Zheng, W., Zhu, Y. et. al. (2016). Modified bronchial anastomosis in video-assisted thoracoscopic sleeve lobectomy: a report of 32 cases. Journal of Thoracic Disease, 8 (8), 2233–2240. doi: http://doi.org/10.21037/jtd.2016.07.74
Broderick, S. R., Patel, A. P., Crabtree, T. D., Bell, J. M., Morgansztern, D., Robinson, C. G. et. al. (2016). Pneumonectomy for Clinical Stage IIIA Non-Small Cell Lung Cancer: The Effect of Neoadjuvant Therapy. The Annals of Thoracic Surgery, 101 (2), 451–458. doi: http://doi.org/10.1016/j.athoracsur.2015.07.022
Kim, A. W., Boffa, D. J., Wang, Z., Detterbeck, F. C. (2012). An analysis, systematic review, and meta-analysis of the perioperative mortality after neoadjuvant therapy and pneumonectomy for non–small cell lung cancer. The Journal of Thoracic and Cardiovascular Surgery, 143 (1), 55–63. doi: http://doi.org/10.1016/j.jtcvs.2011.09.002
Aresu, G., Wu, L., Lin, L., Jiang, G., Jiang, L. (2016). The Shanghai Pulmonary Hospital subxiphoid approach for lobectomies. Journal of Visualized Surgery, 2, 135. doi: http://doi.org/10.21037/jovs.2016.07.09
Weaver, H., Ali, J. M., Jiang, L., Yang, C., Wu, L., Jiang, G., Aresu, G. (2017). Uniportal subxiphoid video-assisted thoracoscopic approach for thymectomy: a case series. Journal of Visualized Surgery, 3, 169–169. doi: http://doi.org/10.21037/jovs.2017.10.16
Liu, H.-F., Gao, L., Liu, T., Yan-Jiang, Wang, H.-B. (2016). Comparison of acute phase reaction and postoperative stress in pigs undergoing video-assisted thoracoscopic versus thoracotomy pneumonectomy. Acta Veterinaria Scandinavica, 58 (1). doi: http://doi.org/10.1186/s13028-016-0256-x
Di Maio, M., Perrone, F., Deschamps, C., Rocco, G. (2014). A meta-analysis of the impact of bronchial stump coverage on the risk of bronchopleural fistula after pneumonectomy. European Journal of Cardio-Thoracic Surgery, 48 (2), 196–200. doi: http://doi.org/10.1093/ejcts/ezu381
Maurizi, G., Ciccone, A. M., Vanni, C., D’Andrilli, A., Ibrahim, M., Andreetti, C. et. al. (2018). Reimplantation of the upper lobe bronchus after lower sleeve lobectomy or bilobectomy: long-term results†. European Journal of Cardio-Thoracic Surgery, 53 (6), 1180–1185. doi: http://doi.org/10.1093/ejcts/ezx494
Cusumano, G., Marra, A., Lococo, F., Margaritora, S., Siciliani, A., Maurizi, G. et. al. (2014). Is Sleeve Lobectomy Comparable in Terms of Short- and Long-Term Results With Pneumonectomy After Induction Therapy? A Multicenter Analysis. The Annals of Thoracic Surgery, 98 (3), 975–983. doi: http://doi.org/10.1016/j.athoracsur.2014.04.095
Boyko, V. V., Krasnoyruzhsky, A. G., Kritsak, V. V. (2017). The choice of photosensitizer and parameters of light radiation for endoscopic endobronchial photodynamic therapy. International Medical Journal, 23, 28–32. Available at: http://nbuv.gov.ua/UJRN/Mmzh_2017_23_2_7
D’Andrilli, A., Maurizi, G., Andreetti, C., Ciccone, A. M., Ibrahim, M., Poggi, C. et. al. (2014). Pulmonary Artery Reconstruction With Pulmonary Vein Conduit for Lung Cancer: Medium-Term Results. The Annals of Thoracic Surgery, 98 (3), 990–995. doi: http://doi.org/10.1016/j.athoracsur.2014.04.110
Nagayasu, T., Yamasaki, N., Tsuchiya, T., Matsumoto, K., Miyazaki, T., Hatachi, G. et. al. (2015). The evolution of bronchoplasty and broncho-angioplasty as treatments for lung cancer: evaluation of 30 years of data from a single institution. European Journal of Cardio-Thoracic Surgery, 49 (1), 300–306. doi: http://doi.org/10.1093/ejcts/ezv065
Maurizi, G., Ibrahim, M., Andreetti, C., D’Andrilli, A., Ciccone, A. M., Pomes, L. M. et. al. (2014). Long-term results after resection of bronchial carcinoid tumour: evaluation of survival and prognostic factors. Interactive CardioVascular and Thoracic Surgery, 19 (2), 239–244. doi: http://doi.org/10.1093/icvts/ivu109
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