Robert J. Luis Miguel Seijo 15 Medical Thoracoscopy. Sjaak A. Burgers 16 Photodynamic Therapy in the Pleural Space. Boyd T. Machuzak, Ali I. Sterman 21 Management of Spontaneous Pneumothorax.
Michael H. William Lunn 23 Management of Massive Hemoptysis. John Conforti 24 Management of Tracheobronchomalacia. Kelly A. SimoffNew technologies for the endobronchial assessment of the pulmonary tractark E.
BrezinskiEndobronchial ultrasoundelix J. BeckerAdvances in diagnostic bronchoscopy: virtual bronchoscopy and advanced airway imagingex C. BalcombeBronchoscopy and computer technologyeinrich D. WoodFire and ice: laser bronchoscopy, electrocautery and cryotherapyichael A.
SilvestriPhotodynamic therapy for endobronchial tumors: palliation and definitive therapyavid Ost0 Stenting of the tracheobronchial treermin Ernst1 Transtracheal oxygen and percutaneous tracheotomyavid Feller-Kopman2 Bronchoscopic lung volume reductiondward P. Tsai3 Endobronchial gene therapyobert J. Stermanart III Interventional pleurology4 Thoracentesis, percutaneous needle biopsy of pleura, small-bore catheterrainage: does size really matter'uis Miguel Seijo5 Medical thoracoscopyjaak A.
Simoff9 Staging of bronchogenic carcinoma: an interventional pulmonary perspective. Sterman1 Management of spontaneous pneumothoraxichael H.
Thoracic Endoscopy Advances in Interventional Pulmonology
Baumann2 Obstruction of the central airways: evaluation and managementilliam Lunn3 Management of massive hemoptysisohn Conforti4 Management of tracheobronchomalaciaelly A. Interventional BronchologyA. Advances in Diagnostic Bronchology Editor: Simoff 1. Autoflorescence Bronchoscopy Michael J. Simoff, MD 2. Endobronchial ultrasound Felix Herth, MD 4. Yung, MD 5. Advances in Therapeutic Bronchology Editor: Ernst 1.
Rigid bronchoscopy in the 21st century Irawan Susanto, MD 2. The rapid progress in interventional pulmonology in Michael J.
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Thoracic Endoscopy by Michael J. Simoff MD,; Daniel H.
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Michael J. Simoff Editor , Daniel H. Sterman Editor , Armin Ernst Editor in the field, Thoracic Endoscopy is the first up-to-the-minute, expert reference for. Endoscopy: Advances in.
Simoff, MD. Written by some of the world's leading practitioners - and pioneers - in the field, Thoracic Endoscopy is the first up-to-the-minute, expert reference for clinicians. Cryotherapy may be too slow or ineffective in some situations, and electrosurgery may be limited due to the angle needed to approach the lesion.
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Extrinsic compression of the airway with essentially normal endoluminal mucosa should never be ablated, but if necessary, stented. The condition of the patient must be taken into consideration when contemplating any bronchoscopic palliation. Patients with a very short life expectancy should not be burdened with invasive palliation, and patients who are unlikely to benefit for other reasons similarly should not be taken through invasive procedures.
Great care must be used to obtain a history and physical examination of the patient, examine available chest imaging and physiologic lung function testing, and to consider the overall impact of interventions and goals of care. Knowledge of vascular and bronchial anatomy is essential when considering palliation, as well as the natural history of the disease and the response of the airway tissues to various treatment techniques.
The use of palliative endobronchial therapy must be carefully balanced between the patient, underlying condition, goals of care, and techniques. If a patient cannot tolerate sedation or anesthesia, endoscopic palliation is less likely to be of benefit. Similarly, if a complete airway obstruction has been present for 6 or more weeks the likelihood of a successful result in opening the airway is very small.
In a cohort of 37 patients with malignant CAO, interventions by experienced operators resulted in significant improvements in 6-minute walk distance, dyspnea scores, FEV1 and FVC at 30 days post-procedure. Quality of life scores improved at day 90 and after treatment. Although the study did not directly compare endoscopic interventions to other palliative therapies such as radiation and chemotherapy, it appears that endoscopic palliation may be superior to these therapies in selected patients.
A significant increase in survival was noted among the subset of fifteen patients who underwent emergency palliative photoresection as the initial therapeutic intervention compared with a subset of eleven patients who received palliative radiation alone. When a group of patients who underwent a combination of Nd: YAG photo-resection and subsequent external-beam radiation therapy was compared with a group that underwent external-beam radiation therapy plus brachytherapy, those in the laser treatment group demonstrated significantly longer survival than those treated with radiation alone.