ABSTRACT
Objective: To explore bronchial balloon dilation (BD) combined with cryotherapy and Photoshop (PS)-base image processing technology in the interventional treatment of tuberculous cicatricial central airway stenosis (CCAS). Methods: This multicenter, retrospective study analyzed the clinical data of patients with CCAS from six hospitals in Henan, China between June 2019 and October 2022. Results: A total of 307 patients were included, including 152 (62 males) treated with BD alone and 155 (54 males) treated with BD combined with cryotherapy. One month after treatment, compared with the BD group, the total response rate [133 (85.8) vs. 105 (69.1), P < 0.001] and occurrence of restenosis at 1-monthaftertreatment [22 (14.2 %) vs. 47 (30.9 %), P < 0.001] in BD & cryotherapy group were significantly higher; furthermore, the inner diameter of the airway stenosis (8.1 ± 0.9 mm vs. 6.4 ± 1.5 mm, P < 0.001), the cross-sectional area of the airway stenosis (51.6 ± 7.8 mm2 vs. 33.1 ± 11.6 mm2, P < 0.001), FEV1 (5.26 ± 0.42 L vs. 4.32 ± 0.31 L, P < 0.001), and PEF (5.72 ± 0.36 L/s vs. 4.56 ± 0.42 L/s, P < 0.001) in BD & cryotherapy group showed significantly more improvements. Moreover, Pearson's correlation analysis showed significantly strong positive correlation (r = 0.818ï¼P < 0.001) between the cross-sectional area of airway stenosis measured by PS-base image processing technology and the inner diameter of airway stenosis measured by chest CT. Conclusion: BD combined with cryotherapy for the interventional treatment of CCAS might be superior to BD alone. PS-base image processing technology might be used as a supplement strategy for measuring the degree of central airway stenosis.
ABSTRACT
BACKGROUND: To examine the benefits of interventional therapy for cicatricial constriction using a high-frequency electric knife, saccular dilatation, and cryotherapy. METHODS: This case series included patients with central tracheobronchial cicatricial constriction admitted to the Department of Tuberculosis of Henan Provincial Chest Hospital from July 2018 to March 2021 and treated with bronchoscopic interventional therapies based on systemic anti-tuberculosis treatment. RESULTS: 96 patients were included, in whom 443 interventional therapies were performed. The total mid-(3 months) and long-term (12 months) effective rates were both 100%. The internal diameter of tracheobronchial stenosis increased after the operation, and the difference was statistically significant (all < 0.05). After interventional treatment, patients' symptoms of choking sensation in the chest and shortness of breath were relieved. Respiratory function was obviously improved. The ratios of hemorrhage, granulation hyperplasia, chest pain, and postoperative fever were 58.2%, 42.6%, 31.3%, and 26.7%, respectively. No focal transmission and progression of tuberculosis occurred, and no serious complications were observed. CONCLUSION: The use of a high-frequency electric knife, saccular dilatation, and/or cryotherapy according to the pathological stage of the tracheobronchial cicatricial constriction is feasible, with good mid- and long-term curative effects and few complications.
