Rigid bronchoscopy for tracheal stenosis

  A hospital thoracic surgery recently successfully completed rigid bronchoscopy for malignant tracheal stenosis and ultrasonic bronchoscopic extra-tracheal tumor particle implantation, successfully treating a patient with breathing difficulties due to malignant tumor, which is the first case in the northeast provinces.  On December 11, 75-year-old Master Wang came to the hospital’s thoracic surgery department for treatment, and the attending thoracic surgeon found by fiberoptic bronchoscopy: the patient had squamous carcinoma of the left main bronchus and 80% stenosis of the left main bronchus. The thoracic enhancement CT showed that the mass invaded the aorta and left atrium, which could not be completely removed by surgery; and due to the poor physical condition of the patient, radiotherapy was not suitable for application. In order to solve the patient’s respiratory distress, the chief and associate professor of thoracic surgery decided to perform “rigid bronchoscopic ablation of tracheal tumor and ultrasonic bronchoscopic implantation of extra-tracheal tumor particles” after consultation with the whole department. The second ward of thoracic surgery performed rigid bronchoscopic tracheal tumor ablation and ultrasonic bronchoscopic extra-tracheal tumor particle implantation for the patient, and the operation was successful. The associate professor who performed the surgery on the patient said, “After the surgery, the patient’s tracheal stenosis was eliminated, the airway was restored to be open, and the symptoms of dyspnea disappeared. The symptoms of obstructive pneumonia caused by tracheal stenosis also basically disappeared, successfully relieving the patient of the symptoms that had plagued him with breathing difficulties for months and greatly improving his quality of life.”  The successful development of rigid tracheoscopy for airway stenosis marked the leading level of the hospital’s thoracic surgery department in the field of interventional pulmonology treatment in China, and the rigid tracheoscopy technology has established a life channel for patients with airway stenosis, bringing hope for patients with benign and malignant tracheal stenosis, and greatly improving the quality of life and survival of patients with such diseases.  Meanwhile, the second ward was the first in Heilongjiang province to carry out ultrasonic bronchoscopic needle aspiration biopsy (EBUS-TBNA) for lung cancer staging and mediastinal mass biopsy in July 2014, and this technique has become a characteristic technique of the department. Since the patient is not suitable for radiotherapy, particle implantation is feasible for the control of the peri-tracheal mass, but since the mass is near the heart and large blood vessels, percutaneous puncture for particle implantation is extremely risky and may damage the heart and large blood vessels and endanger the patient’s life, but particle implantation under ultrasound bronchoscopy effectively avoids this risk, as the mass and large blood vessels of the heart can be distinguished under ultrasound bronchoscopy, avoiding the risk of puncture damage to large blood vessels of the heart. The risk of puncture damage to the large blood vessels of the heart is avoided.