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[The efficacy of endobronchial argon plasma coagulation in the management of intraluminal obstructive lesions of the central airway].

OBJECTIVE
To evaluate the efficacy of endobronchial argon plasma coagulation (APC) in the management of intraluminal obstructive lesions of the central airway.


METHODS
A total of 53 patients (37 males, 16 females), aged from 14 to 82 years (mean 55), with intraluminal obstructive lesions of the central airways were selected, including 28 cases of malignancies, 13 cases of benign tumors and 12 cases of other diseases. Endoscopic management of these lesions with APC 300 (ERBE, Germany) was performed under local or general anesthesia. The result of treatment was evaluated according to recanalization of the obstructed airway and clinical data.


RESULTS
There were 86 lesions in the 53 cases. Success rates for resecting the lesions were > 97% (35/36) in the trachea, 79% (22/28) in the mainstem bronchi, and 64% (14/22) in the intermediate bronchus and lobe bronchi. The success rate for resecting benign lesions (92%, 34/37) was higher than for malignant lesions (76%, 37/49). Eighteen cases with respiratory failure caused by the lesions were immediately relieved after APC therapy under general anaesthesia and mechanical ventilation.


CONCLUSIONS
APC is an effective method for resecting intraluminal obstructive lesions of the central airways. APC produces immediate effects, and may be life-saving for patients with airway obstructing lesions requiring emergent endoscopic treatment. General anaesthesia and mechanical ventilation can be used to increase successful rates and safety of interventional therapy in severe cases.