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https://www.readbyqxmd.com/read/29433718/pediatric-interventional-pulmonology
#1
REVIEW
Leonardo Donato, Thi Mai Hong Tran, Uzair K Ghori, Ali I Musani
Although controversy over the role of flexible versus rigid bronchoscopy for airway foreign body management persists, the effort should focus on prevention of aspiration of foreign bodies instead. This article discusses several recent advances in the bronchoscopic management of congenital tracheal stenosis, pediatric airway stenting, and the use of different types of lasers in children. The lack of randomized clinical trials leaves pediatric interventional bronchoscopic procedures without much national or international standards or guidelines...
March 2018: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/29433711/the-art-of-rigid-bronchoscopy-and-airway-stenting
#2
REVIEW
Antoinette Flannery, Cyrus Daneshvar, Hervé Dutau, David Breen
Interventional pulmonology has grown significantly over the last 2 decades and is now seen as an essential component in thoracic oncology care. The rigid bronchoscope occupies a central role in this specialty and offers many important advantages over the flexible scope when performing therapeutic procedures on central airways. Although stenting practices have evolved, it is generally accepted that stents offer an important treatment option for selected patients with benign and malignant airway diseases. This article discusses rigid bronchoscopy and stenting, future challenges, complications of the procedure and stents, and future directions...
March 2018: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/29427616/complex-tracheo-carinal-reconstructions-using-extrathoracic-muscle-flaps-as-airway-substitutes
#3
Jeanine Blatter, Thorsten Krueger, Hans-Beat Ris, Moira Baeriswyl, Alban Lovis, Mathieu Zellweger, Michel Gonzalez, Jean Yannis Perentes
BACKGROUND: Extrathoracic muscle flaps can be used as airway substitutes for the closure of complex broncho-pleural or tracheo-esophageal fistulas or in the context of tracheo-carinal reconstructions after resection for centrally localized tumors in order to alleviate excess anastomotic tension. METHODS: Evaluation of all patients undergoing tracheo-carinal reconstructions with extrathoracic muscle flap patches as airway substitutes in our institution from 1996 to 2016...
February 7, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29420596/flexible-endoscopy-for-pediatric-tracheobronchial-metallic-stent-placement-maintenance-and-long-term-outcomes
#4
Wen-Jue Soong, Pei-Chen Tsao, Yu-Sheng Lee, Chia-Feng Yang
OBJECTIVES: To assess the placement, surveillance management and long-term outcomes of the tracheobronchial (TB) balloon expandable metallic stent (BEMS) managed by therapeutic flexible endoscopy (TFE). METHODS: This is a retrospective review and analysis of all computerized medical records and related flexible endoscopy videos of pediatric patients who received TB BEMS during 20 years period, from January 1997 to December 2016. TFE techniques with forceps debridement, balloon dilatation and laser ablation were used to implant stents, perform regular surveillance, maintain their functions, and expand the diameters of BEMS...
2018: PloS One
https://www.readbyqxmd.com/read/29392975/respiratory-digestive-tract-fistula-two-center-retrospective-observational-study
#5
Sameh I Sersar, Lamees A Maghrabi
Background Aerodigestive fistulae can be defined as abnormal communications between the gastrointestinal tract and the respiratory tract. Choking after meals, coughing, feeding difficulties, tachycardia, and persistent pneumonia are the main presentations. The aim of our study was to review our experience in the management of 27 cases of acquired aerodigestive fistulae of different types, levels, and management. Methods We conducted a retrospective observational study on 27 cases of fistulae between the respiratory and digestive tracts, which were managed in 2 hospitals in Saudi Arabia in the last 5 years...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29363641/scarring-airway-stenosis-in-chinese-adults-characteristics-and-interventional-bronchoscopy-treatment
#6
Ting Wang, Jie Zhang, Xiao-Jian Qiu, Juan Wang, Ying-Hua Pei, Yu-Ling Wang
BACKGROUND: Scarring airway stenosis is commonly seen in China as compared to other developed countries, due to the high prevalence of tuberculosis. Nowadays, interventional bronchoscopy treatment has been widely used to treat this disease in China. This study demonstrated the characteristics of scarring airway stenosis in Chinese adults and retrospectively evaluated the efficacy of interventional bronchoscopy treatment of this disease. METHODS: Patients with scarring airway stenosis from 18 tertiary hospitals were enrolled between January 2013 and June 2016...
February 5, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29346562/scaffold-free-trachea-regeneration-by-tissue-engineering-with-bio-3d-printing
#7
Daisuke Taniguchi, Keitaro Matsumoto, Tomoshi Tsuchiya, Ryusuke Machino, Yosuke Takeoka, Abdelmotagaly Elgalad, Kiyofumi Gunge, Katsunori Takagi, Yasuaki Taura, Go Hatachi, Naoto Matsuo, Naoya Yamasaki, Koichi Nakayama, Takeshi Nagayasu
OBJECTIVES: Currently, most of the artificial airway organs still require scaffolds; however, such scaffolds exhibit several limitations. Alternatively, the use of an autologous artificial trachea without foreign materials and immunosuppressants may solve these issues and constitute a preferred tool. The rationale of this study was to develop a new scaffold-free approach for an artificial trachea using bio-3D printing technology. Here, we assessed the circumferential tracheal replacement using scaffold-free trachea-like grafts generated from isolated cells in an inbred animal model...
January 15, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29346253/an-innovative-solution-for-prolonged-air-leaks-the-customized-endobronchial-silicone-blocker
#8
Ravindra M Mehta, Abhinav Singla, Rajani S Bhat, Rakesh Godara, Chakravarthi Lokanath, Michael Cutaia
BACKGROUND: Prolonged air leak (PAL) is a life-threatening condition that can present either as bronchopleural fistula, or alveolar-pleural fistula (APF). Although numerous bronchoscopic treatments are described, they are either expensive, not widely available in the developing world or have limited success. We describe our experience with a novel customized endobronchial silicone blocker (CESB) for PAL treatment. METHODS: This is a retrospective study of PAL patients who underwent CESB placement...
January 16, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29333837/-biodegradable-airway-stent-for-the-treatment-of-bronchial-obstruction-in-the-child-case-report
#9
Giselle Cuestas, Verónica Rodríguez, Flavia Doormann, Patricio Bellia Munzón, Gastón Bellia Munzón
Bronchial obstruction is infrequent in the child. The main cause is malacia or benign stenosis. Management alternatives range from conservative treatment to complex surgical and/or endoscopic techniques. Placement of a stent can play a key role in situations where there is no other therapeutic option. However, the ideal stent is not yet available. In the last few years, progress has been made in the development and characterization of novel biodegradable materials in order to overcome the drawbacks of traditional stents made of silicone or metal...
February 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29315465/ventilation-strategy-and-anesthesia-management-in-patients-with-severe-tracheal-stenosis-undergoing-urgent-tracheal-stenting
#10
J-H Zhu, M Lei, E-G Chen, Q Qiao, T-D Zhong
BACKGROUND: Stenting of airway stenosis is a common procedure in specialized centers. The aim of this study was to summarize our clinical experience in ventilation strategy and anesthesia management of patients undergoing urgent tracheal stenting. METHODS: Clinical data of 22 patients with severe tracheal stenosis who underwent urgent endoscopic placement of a tracheal stent during a 2-year period were retrospectively reviewed. The efficacy and safety of different ventilation strategies and veno-arterial extracorporeal membrane oxygenation (ECMO), individualized based on the cause and location of tracheal narrowing, were evaluated...
January 7, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29261574/lobar-airway-stents-proceed-with-caution
#11
Ray W Shepherd
No abstract text is available yet for this article.
January 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29242258/ers-statement-interventional-bronchoscopy-in-children
#12
Ernst Eber, Juan L Antón-Pacheco, Jacques de Blic, Iolo Doull, Al Faro, Raffaella Nenna, Thomas Nicolai, Petr Pohunek, Kostas N Priftis, Paola Serio, Courtney Coleman, Sarah Masefield, Thomy Tonia, Fabio Midulla
Paediatric airway endoscopy is accepted as a diagnostic and therapeutic procedure, with an expanding number of indications and applications in children. The aim of this European Respiratory Society task force was to produce a statement on interventional bronchoscopy in children, describing the evidence available at present and current clinical practice, and identifying areas deserving further investigation. The multidisciplinary task force panel performed a systematic review of the literature, focusing on whole lung lavage, transbronchial and endobronchial biopsy, transbronchial needle aspiration with endobronchial ultrasound, foreign body extraction, balloon dilation and occlusion, laser-assisted procedures, usage of airway stents, microdebriders, cryotherapy, endoscopic intubation, application of drugs and other liquids, and caregiver perspectives...
December 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29238992/an-innovative-solution-for-t-tube-obstruction-the-tracheostomy-customized-stent-combination
#13
Ravindra M Mehta, Abhinav Singla, Rajani S Bhat, Rasika Rao, Ritesh Agarwal
The Montgomery T-tube (MTT) is a useful tool for post-tracheostomy tracheal stenosis. However, MTTs can get blocked. We present a case series of life-threatening MTT blockage, wherein a split-function option was implemented, which was a customized silicone Dumon stent above the tracheostomy to maintain both airway and phonation. This tracheostomy-customized stent combination serves the same function as an MTT, with a greater margin of safety due to the easy suctioning capacity of the tracheostomy. With a fenestrated tracheostomy and stent above, speech is effectively preserved...
December 14, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29221291/airway-stenting-in-patients-requiring-intubation-due-to-malignant-airway-stenosis-a-10-year-experience
#14
Masahide Oki, Hideo Saka, Kazumi Hori
Background: Critically ill patients with severe acute respiratory failure due to malignant airway stenosis often require emergency intubation and mechanical ventilation. Urgent intervention is necessary for the survival of such patients. The aim of this study was to determine the efficacy and outcomes of airway stenting in patients with malignant airway stenosis requiring emergency intubation. Methods: Patients with malignant airway stenosis who underwent emergency intubation prior to airway stent placement from September 2005 to September 2015 in a single center were retrospectively reviewed...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29214067/malignant-central-airway-obstruction
#15
REVIEW
Lakshmi Mudambi, Russell Miller, George A Eapen
This review comprehensively describes recent advances in the management of malignant central airway obstruction (CAO). Malignant CAO can be a dramatic and devastating manifestation of primary lung cancer or metastatic disease. A variety of diagnostic modalities are available to provide valuable information to plan a therapeutic intervention. Clinical heterogeneity in the presentation of malignant CAO provides opportunities to adapt and utilize endoscopic technology and tools in many ways. Mechanical debulking, thermal tools, cryotherapy and airway stents are methods and instruments used to rapidly restore airway patency...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29190612/assessment-of-bronchial-obstruction-using-lateral-pressure-measurement-during-bronchoscopy
#16
Hiroki Nishine, Takehiko Hiramoto, Takeo Inoue, Naoki Furuya, Hirotaka Kida, Hiroshi Handa, Seiichi Nobuyama, Masamichi Mineshita, Teruomi Miyazawa
BACKGROUND: In patients with bronchial obstruction estimating the location of the maximal obstruction is crucial for guiding interventional bronchoscopy. However, flow-volume curves cannot discriminate between the right and left lungs. OBJECTIVES: The aim of this study was to physiologically evaluate bronchial obstruction during interventional bronchoscopy. METHODS: We prospectively measured lateral airway pressure (Plat) at either side of the obstruction using a double-lumen catheter (pressure-pressure [P-P] curve) simultaneously to assess the degree of bronchial obstruction in 22 patients...
November 30, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29177931/evaluating-the-interaction-of-a-tracheobronchial-stent-in-an-ovine-in-vivo-model
#17
Donnacha J McGrath, Anja Lena Thiebes, Christian G Cornelissen, Barry O'Brien, Stefan Jockenhoevel, Mark Bruzzi, Peter E McHugh
Tracheobronchial stents are used to restore patency to stenosed airways. However, these devices are associated with many complications such as stent migration, granulation tissue formation, mucous plugging and stent strut fracture. Of these, granulation tissue formation is the complication that most frequently requires costly secondary interventions. In this study a biomechanical lung modelling framework recently developed by the authors to capture the lung in-vivo stress state under physiological loading is employed in conjunction with ovine pre-clinical stenting results and device experimental data to evaluate the effect of stent interaction on granulation tissue formation...
November 24, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/29174374/tracheobronchial-stenting-for-airway-malacia
#18
REVIEW
Colin Wallis, Clare A McLaren
Tracheobronchomalacia is a rare but clinically troublesome condition in paediatrics. The softening of the major airways - which can include some or all of the tracheobronchial tree can lead to symptoms ranging from the minor (harsh barking cough, recurrent chest infections) to severe respiratory difficulties including prolonged ventilator support and 'near death attacks'. The causes are broadly divided into intrinsic softening of the airway wall which is considered a primary defect (e.g. syndromes; post tracheo-oesophageal fistula repair; extreme prematurity) or secondary malacia due to external compression from vascular structures or cardiac components...
October 13, 2017: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/29151293/-clinical-analysis-of-36-cases-of-advanced-non-small-cell-lung-cancer-nsclc-with-performance-status-ps-scores-between-2-and-4
#19
Y Y Qin, D H Zhang, X Q Lin, M Ouyang, J X Zhang, Z H Xie, Y Q Liu, S Y Li, C Z Zhou
Objective: To analyze the treatment of advanced non-small cell lung cancer (NSCLC) with performance status (PS) scores between 2 and 4, in order to improve the diagnosis and treatment of these patients. Methods: A total of 36 patients with advanced NSCLC with hypoxemia were reviewed. The clinical data of disease characteristics, etiology, complications, manifestation, therapy, progression, and secondary biopsy were collected. The clinical efficacy was graded according to the Response Evaluation Criteria In Solid Tumors (RECIST): complete response (CR), partial response (PR), stable disease (SD) and disease progression (PD)...
November 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/29128019/airway-complications-after-lung-transplantation
#20
REVIEW
Laura Frye, Michael Machuzak
Airway complications remain a significant source of morbidity and mortality after lung transplantation. The incidence of complications is wide-ranging depending on the definition of the event, and there is still no universally accepted grading system for airway findings after transplantation. Additionally, although surgical technique and organ preservation have improved, other modifiable risk factors remain unclear. The management is as wide-ranging as the definitions. A multimodality approach is often needed with airway stenting reserved for refractory cases and stent management by a transplant team with expertise in placement and management of long-term complications...
December 2017: Clinics in Chest Medicine
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