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Ryosuke Amemiya



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    P3.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 982)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.16-27 - Clinical Outcome of Preoperative Intervention Bronchoscopy Followed by Surgery (ID 13111)

      12:00 - 13:30  |  Author(s): Ryosuke Amemiya

      • Abstract
      • Slides

      Background

      The report of patients with respiratory disease who could receive surgery after bronchial intervention (IVB) is relatively rare. We still experience patients with advanced lung cancer that develops with severe dysplasia and bleeding. To assess the usefulness intervention bronchoscopy combined with surgery.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We experienced a total of 5 lung cancer patients treated by surgery after IVB at Tokyo Medical University Ibaraki Medical Center. Chief complain were severe dysplasia in 4 cases and bronchial bleeding in one case. The lesions were located at central bronchus in 4 cases. Histological types were 2 squamous cell carcinomas, 1 adenocarcinoma, 1 large cell carcinoma, and 1 pleomorphic carcinoma. Endobronchial snare & argon plasma coagulation (APC) were firstly performed in 2 cases, airway stentings using Dumon stent or Dumon-Y stent in 2 cases, and endobronchial Watanabe spigot (EWS) in 1 case. We evaluated the clinical outcome retrospectively.

      4c3880bb027f159e801041b1021e88e8 Result

      4 cases with obstructive lesions were treated by endobronchial snare and APC, and the other 2 cases were used bronchial stent. EWS was used to occlude the bronchi in the purpose of stopping blood aspiration in advanced adenocarcinoma case. After reducing the massive bleeding using EWS, we could perform salvage surgery. Performance status improved from 2 and 3 to 1 in all patients. All cases showed their symptom improvements after IVB, and were examined full staging (cT4N0M0) and checked operative risk. Thereafter, we could undergo salvage surgery (lobectomy: 2, bi-lobectomy: 1, pneumonectomy: 1, tracheoplasty: 1, carinoplasty: 1). Mean time of IVB followed by surgery was 115.7 days. Overall survival was 22.5 months (1-107.2 months), 5 years survival was 50%, and recurrent rate was 40% (2/5), respectively.

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      8eea62084ca7e541d918e823422bd82e Conclusion

      IVB followed by surgery is useful modality, and we should realize that there are some patients who can be treated by surgery after IVB because of improvements of their conditions. Also, IVB can be effective for reducing performance status.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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