Figures
- Figure 1
Relationship between the rigid and flexible bronchoscopes and the laser fibre. The tip of the optical fibre must always protrude well beyond the bronchoscope to avoid thermal damage. Reproduced from [23] with permission from the publisher.
- Figure 2
a) Flow–volume loops obtained before and after laser treatment for a patient with an adenoid cystic carcinoma of the trachea (b). The patient was originally misdiagnosed as having severe COPD. Reproduced from [23] with permission from the publisher.
- Figure 3
a typical carcinoid situated in close proximity to the main carina a) before and b) after endoscopic laser resection.
- Figure 4
Cryoprobe console.
- Figure 5
A large piece of tumour removed from the promixal right main bronchus with a cryoprobe. Reproduced from [23] with permission from the publisher.
- Figure 6
An endobronchial stent in place with granulation tissue present at the distal end.
- Figure 7
Stent deploying system (Aero; Merit Endotek).
- Figure 8
Another stent deploying system (Polyflex stent, Boston Scientific).
- Figure 9
Treatment of an early lung cancer with PDT. The PDT fibre is placed alongside early cancer.
- Figure 10
Debris present during post-PDT bronchoscopy.
Tables
- Table 1
Indications, contraindications and complications from endobronchial laser treatment
Indications Contraindications Complications Palliation Extrinsic compression Fire Debulking of endobronchial tumour and immediate palliation of endobronchial obstruction due to lung primary/metastasis (e.g. prostate, oesophagus, colon, etc.) Broncho-oesophageal fistula Fistula formationHypoxaemia Treatment Coagulopathy Bleeding Endobronchial early stage lung cancer not amenable to conventional treatment (surgery, radiotherapy), including typical carcinoids Airway wall necrosis Endobronchial stenosis due to benign conditions Air embolism Previous intubation/tracheostomy, granulomatosis with polyangiitis, sarcoidosis etc. Respiratory insufficiency secondary to aspiration of smoke produced by laser Benign endobronchial lesions e.g. papilloma, fibroma, leiomyoma etc Pneumothorax Peri-/postoperative cardiac-cerebral incidents Pneumomediastinum Debris/blood clot formation - Table 2
Indications for endobronchial brachytherapy
Indications Curative Palliation Early invasive mucosal or submucosal non-small cell lung cancer in poor candidates for radical treatments and/or poor performance status √ Infiltrative tumour with endobronchial disease not causing life threatening airway obstruction (locally advanced central lung cancer) √ Endobronchial boost to full course external beam radiation therapy with incomplete response/recurrence √ Post-operatively in the presence of positive resection margins √
