Abstract
Background and Purpose. Unilateral atelectasis due to malignant main bronchus obstruction causes severe dyspnea. For such cases, although Nd-YAG laser vaporization was mainly used as a method of re-expansion in an emergency, it was reported that a fire can break out in the airway under hyperdense oxygenation. We analyzed the safety and effectiveness of microwave coagulation therapy to expand and open the occluded airway under the hyperdense oxygenation. Patients and Methods. We analyzed a review of 11 patients with re-expansion of the occluded airway by microwave coagulation therapy who had already had unilateral complete atelectasis due to malignant main bronchus obstruction in the first medical examination, between April 1993 and March 2006. All patients had unilateral complete atelectasis due to complete obstruction of main bronchus. The subjects were 7 men and 4 women between 42 and 75 years of age (median: 64). There were 8 cases of primary lung cancer (6 squamous cell carcinoma, 2 adenocarcinoma), and 1 each of metastasis of renal cancer, colon cancer and esophageal cancer. In primary lung cancer, 6 out of 8 cases occurred in the upper lobe and 2 in the lower lobe. Results. Nine cases had air filling in the upper lobe, lower lobe or middle and lower lobe and 2 cases had air filling in the upper and lower lobes by microwave coagulation therapy from 1 day (time) to 4 days (times). Immediately after re-expansion, there was a great flow of retained sputum. After re-expansion, there was no re-expansion pulmonary edema and stents were inserted in 10 cases. Symptoms in all cases and performance status in 10 cases improved on completion of endoscopic therapy finished. It was possible for 7 cases to undergo secondary treatment of chemotherapy or radiotherapy and for 9 cases to leave hospital. All cases were inoperable. Conclusion. It is possible to expand and open the occluded airway by microwave coagulation under the hyperdense oxygenation. We think microwave coagulation therapy has excellent safety and effectiveness.
