IT IS TIME FOR ENDOBRONCHIAL THERAPY TO REPLACE SURGERY IN THE TREATMENT OF TYPICAL BRONCHIAL CARCINOID

Abstract

SESSION TITLE: Lung Cancer Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: To diagnose and treat benign endobonchial tumors by cryo procedure.To discover the efficacy of cryo approach in diagnosis and treatment of typic carcinoid , endobronchial hamartoma and papilomatosis METHODS: Patients were consulted at tertiary care between 2016-2019.Patients underwent Chest X Ray examinations, Chest computed tomography (CT) and flexible bronchoscopy, cryo biopsy. Eight of them resulted in typical carcinoid, three with endobronchial hamartomas and one with tracheal papillomatosis. The patients signed consensus to continue endobronchial treatment.All of them hadn’t adenopathy and hadn’t bronchial wall infiltration All patients underwent general anesthesia. bronchoflex tube was used for intubation through which we put the balloon for hemostasis by fibrobronchoscop. The patients underwent devitalisations, debulking and cryotherapy of endobronchial mass. All patients have been successfully treated with complete tumor resection and received cryotherapy to base implantation of tumor RESULTS: Twelve patients underwent endobronchial treatment with the combination of cryo therapy with electrocautery.Eight patient had typical carcinoid, three women and five men. Three patients were diagnosed with endobronchial hamartoma two men and one woman. One patient with tracheal papillomatosis. The median age of patients with carcinoid was 45 years. Only one patient had smoked. These patients were followed up with flexible bronchoscopy every three months, with Chest computed tomography and flexible bronchoscopy after 6 months and each year. Median follow-up was 27 months with Flexible bronchoscopy and Chest computed tomography . So far none of the patients have had local or remote relapses. CONCLUSIONS: According to these results and other authors, for typical carcinoid, it is time to replace surgery with less invasive and safer procedure, endobronchial therapy such as cryo approach. CLINICAL IMPLICATIONS: The main complication was hemorrhage which was managed with balloon and TA reduction. In all cases of significant haemorrhage,the patients have been with arterial blood pressure in the range of 130-140 mmHg. Lowering arterial blood pressure below 120 mmHg is a necessary action for the rapid management of hemorrhage. DISCLOSURES: no disclosure on file for Prof.Dr Perlat Kapisyzi; no disclosure on file for Fahri Kokici; no disclosure on file for ilir peposhi; No relevant relationships by Eritjan Tashi, source=Web Response No relevant relationships by Alma Teferici, source=Web Response no disclosure on file for Daniela Xhemalaj