RESUMO
We investigate retrospectively the efficacy of self-expandable metallic stents (SEMS) for severe respiratory distress (SRD) in patients with central airway obstruction (CAO). Thirty three patients with CAO were treated with SEMS using fiberoptic bronchoscopy method. We found an intraluminal obstruction present in 7, extraluminal compression in 10, and combined stenosis in 16 cases. Tumor infiltration occupied more than 90% of the endoluminal diameter in 21, 70% in 9, and 50% in 3 cases. Obstruction was caused by primary cancer of lung in 23, thyroid in 5, and esophagus in 5 patients. Up to 3 stents per patient were placed. Double stenting (esophagus and trachea) was required in five patients. All patients exhibited symptomatic and arterial blood gas improvement. The mean follow-up was 65 (5 to 752) days. SEMS are useful for the treatment of SRD caused by CAO. The overall effect is related to the degree of tumor progression itself.
Assuntos
Obstrução das Vias Respiratórias/complicações , Obstrução das Vias Respiratórias/terapia , Síndrome do Desconforto Respiratório/etiologia , Síndrome do Desconforto Respiratório/terapia , Stents , Idoso , Obstrução das Vias Respiratórias/patologia , Monitorização Transcutânea dos Gases Sanguíneos , Broncoscopia , Neoplasias Esofágicas/complicações , Feminino , Humanos , Neoplasias Pulmonares/complicações , Masculino , Pessoa de Meia-Idade , Oxigênio/sangue , Síndrome do Desconforto Respiratório/patologia , Doenças Respiratórias/complicações , Stents/efeitos adversos , Neoplasias da Glândula Tireoide/complicações , Tomografia Computadorizada por Raios X , Traqueia/patologia , Resultado do TratamentoRESUMO
The immunophenotype of peripheral blood lymphocytes was evaluated in 50 renal cell carcinoma (RCC) patients, before and after embolization. In RCC patients we have observed significant decrease in the total lymphocyte number as well as in T lymphocyte, their subpopulations and B lymphocyte number. Ten to twelve months after the treatment by embolization, significant increase in the total number of not only lymphocytes (p < 0.001), including T lymphocytes (p < 0.001), T-helper lymphocytes (p < 0.05), cytotoxic T lymphocytes (p < 0.05) and B lymphocytes (p < 0.05), but also an increase of NK cells number (p < 0.05) were found, compared to the values obtained before the treatment and reached the level observed in healthy subjects. Cytometric evaluation of peripheral blood lymphocytic phenotype in renal cell carcinoma patients can help evaluate the immune status of RCC patients as well as assess the embolization efficiency.