Cryo-Forum

From: Proceedings 10th World Congress of Cryosurgery
Endoscopic cryotherapy of tracheal and bronchial tumors - more than ten years experience

November 1998
M Pesek, I Bruha, M Terl, J Straus Plzcn, Faculty of Medicine, Department of Tuberculosis and Pneumology, SMT Cryo Prague, Czech Republic

The authors present results of the endobronchial cryotherapy with fluid-nitrogen utilizing systems, which they developed, and results of others by them utilized minimal-invasive procedures (i.e., laser-coagulation, resection, hyperthermia, electrodiathermia, afterloading).

Treatments were performed in most cases in the general anesthesia with jet-ventilation. With the above-mentioned methods or with their combinations, there were treated 130 patients altogether, with severe malignant obstruction of large airways. While in cases of a malignant stenosis the efficacy has been cca 70%, in benign stenosis this therapy has been curative at all times.

There were not any serious complications. Of 19 patients, there were less serious one. The authors conclude preferable indications, and controindications for an indication of the particular methods. They consider these methods as to each other combination - and complementarable.

Patients with epidermoid carcinomas of large airways, the authors support a combination of laser coagulation with cryotherapy over the laser - or cryotherapy alone. In lung cancer patients, four main types of systemic cellular immunity activation were distinguished. Cytotoxic type, either strong or weak, passive (suppressive) or even none.

Cryodestruction due to tumor antigen release should result in either stimulation or depression of immune response. So far, cryotherapy should be understood as cytoreductive treatment more than immunotherapy.

Key words: bronchoscopy, cryotherapy, laser-coagulation, laser-resection, laser-hyperthermia, cellular immunity

 


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