Virtual Library
Start Your Search
Jiayuan Sun
Author of
-
+
IBS10 - Tracheal Tumours (Ticketed Session) (ID 47)
- Event: WCLC 2019
- Type: Interactive Breakfast Session
- Track: Thymoma/Other Thoracic Malignancies
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 07:00 - 08:00, San Francisco (2009)
-
+
IBS10.02 - Endoscopic Treatment of Unresectable Tumors of the Trachea (Now Available) (ID 3364)
07:00 - 08:00 | Presenting Author(s): Jiayuan Sun
- Abstract
- Presentation
Abstract
Surgical excision and reconstruction remain the recommended treatment approachs for patients with trachea tumors. However, it is associated with significant trauma and the risk of severely damaged pulmonary function, and not all patients are therefore willing to receive or fit for surgical resection. Traditional chemotherapy and radiotherapy can’t improve the prognosis of these patients, which requires a multidisciplinary treatment. Endoscopic treatments, including electrocoagulation, argon plasma coagulation (APC), laser, photodynamic therapy (PDT), cryotherapy, balloon dilatation, stent placement, etc., have been demonstrated to be effective methods in the treatment of the trachea tumors.
For tracheostenosis caused by malignant tumors, the first thing we should do is to relieve the symptoms and keep stable vital signs, so that we can seek chance for the patients to receive other therapies. Ablation therapy only or ablation therapy combined with stent placement are recommended for intraluminal obstructive stenosis. For external pressure stenosis and mixed stenosis, stent placement only and ablation therapy combined with stent placement are recommended, respectively.
Some endoscopic treatments are also recommended for patient with early central lung cancer that is ineligible for surgery by British Thoracic Society Guidelines and American College of Chest Physicians Guidelines [1,2]. Endobronchial ultrasonography can help determine the depth of tumor invasion of the tracheobronchial wall, which can be used for the staging of early central lung cancer to provide guidance for the treatment [3]. Previous study demonstrated that cryotherapy was an effective method in early superficial bronchogenic carcinoma, which could be proposed as a first-line therapy in the population with high carcinogenic risk [4]. Hybrid technology, an innovate technique, combining water jet function with APC, is being used in the clinical practice. It can create a water cushion, providing shelter for the tissues under submucosa, and then the lesion can be ablated effectively and safely (Figure 1) [5].
Endoscopic treatments are performed through natural orifice and have advantages of less trauma, repeatability and lower cost, which is becoming one of the most important treatment methods. Patients can benefit more from endoscopic treatments, especially in patients with unresectable tumors, low-grade malignant trachea tumors, early central lung cancers, and benign trachea tumors.
Reference
1. Kennedy TC, McWilliams A, Edell E, et al. Bronchial intraepithelial neoplasia/early central airways lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest 2007; 132(3 Suppl):221S-233S.
2. Du Rand IA, Barber PV, Goldring J, et al. Summary of the British Thoracic Society guidelines for advanced diagnostic and therapeutic flexible bronchoscopy in adults. Thorax 2011; 66(11):1014-1015.
3. Kurimoto N, Murayama M, Yoshioka S, et al. Assessment of usefulness of endobronchial ultrasonography in determination of depth of tracheobronchial tumor invasion. Chest 1999; 115(6):1500-1506.
4. Deygas N, Froudarakis M, Ozenne G, et al. Cryotherapy in early superficial bronchogenic carcinoma. Chest 2001; 120(1):26-31.
5. Zheng X, Herth FJ, Sun J. Initial Experience with Hybrid-Argon Plasma Coagulation as a Novel Local Treatment Method for Tracheobronchial Mucoepidermoid Carcinoma. Respiration 2019. Accepted.
Figure 1. Hybrid-Argon Plasma Coagulation (APC) therapy in the treatment of an adult patient with tracheobronchial mucoepidermoid carcinoma. CT showed a nodule in intermediate bronchus, completely obstructing the airway (A1-2); large neoplasm in the intermediate bronchus detected by WLB, AFI, and NBI (A3-5); pathologic images indicated MEC (A6-8); invasivion size evaluated by rpEBUS after snare incision (B1-3); light blue water cushion created by Hybrid-APC (B4); Hybrid-APC ablation (B5-6); bronchoscopic inspection by WLB, AFI, and NBI, and evaluation by rpEBUS after first Hybrid-APC therapy (C1-4); light blue cushion created by Hybrid-APC (C5); 2nd Hybrid-APC ablation (C6); CT scan at 4-month follow-up revealed no recurrence (D1-2); bronchoscopy reexamination by WLB and AFI and invasive evaluation by rpEBUS at 4-month follow-up (D3-5); pathological images at 4-month follow-up revealed no recurrence (D6).
Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
-
+
OA01 - Advanced Diagnostic Approaches for Intrathoracic Lymph Nodes and Peripheral Lung Tumors (ID 117)
- Event: WCLC 2019
- Type: Oral Session
- Track: Interventional Diagnostics/Pulmonology
- Presentations: 1
- Now Available
- Moderators:Marioara Simon, Tim Murgu
- Coordinates: 9/08/2019, 10:30 - 12:00, Melbourne (1991)
-
+
OA01.07 - Ultrathin Bronchoscopy Combined with VBN and EBUS for the Diagnosis of PPLs With or Without Fluoroscopy: A Randomized Trial (Now Available) (ID 2242)
10:30 - 12:00 | Presenting Author(s): Jiayuan Sun
- Abstract
- Presentation
Background
Since the utility of low‑dose computed tomography screening for lung cancer, the detection rate of ground‑glass nodules (GGNs) has increased.Transbronchial biopsy for peripheral pulmonary lesions is generally performed using ultrathin bronchoscopy combined with virtual bronchoscopic navigation (VBN) and endobronchial ultrasound (EBUS). The use of fluoroscopy with this method has not yet been explored. The study was designed as a randomized trial to determine the role of fluoroscopy in this method.
Method
Patients with peripheral pulmonary lesions suspicious for malignant were enrolled in the study and randomized to two groups, fluoroscopy group and non-fluoroscopy group. Fluoroscopy group was performed with a 3.0 mm external diameter and 1.7 mm internal diameter ultrathin bronchoscope, EBUS, VBN guidance and fluoroscopy. Non-fluoroscopy group was performed with the same ultrathin bronchoscopy combined with EBUS and VBN guidance, but without fluoroscopy. Biopsies Cytological and histological examinations were performed in both groups.
Result
A total of 126 patients were enrolled and randomized, of whom 120 patients (60, non-fluoroscopy group; 60, fluoroscopy group) were analyzed. The diagnostic yield was 75% (14 benign and 46 malignant lesions) in the non-fluoroscopy group and 83.3% (6 benign and 54 malignant lesions) in the fluoroscopy group (P=0.37). There were no obvious complications including pneumothorax, bleeding, chest pain and pneumonia in both groups.
Conclusion
There was no difference in the diagnostic yield of the non-fluoroscopy group method compared to the FG method using ultrathin bronchoscopy, navigational technology and EBUS for transbronchial biopsy to diagnose peripheral pulmonary lesions.
Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
