90% airway stenosis in the 70s

Text and photos/Yangcheng Evening News All Media Reporter Zheng Da Correspondent Jiang Xin

Recently, Liu Jing, director of the Department of Respiratory and Critical Care Medicine, CUHK Fifth Hospital, and Liu Dezhao, director of the Department of Surgical Anesthesiology, successfully performed rigid bronchoscopy on a patient with severe tracheal stenosis caused by malignant tumor. Partial destruction of airway tumors.

Medical staff operating on patients Photo courtesy of respondents

More than a year ago, a 72-year-old grandpa Huang found a mediastinal mass during a physical examination. He was diagnosed with a malignant tumor and invaded the trachea. He received anti-tumor treatment in another hospital. Recently, he has repeatedly coughed, expectorated sputum, and hemoptysis, but he did not care. A few days ago, he suddenly had difficulty breathing after coughing, and he felt suffocating. He was sent to the Fifth Hospital of CUHK for treatment. The emergency CT examination showed tumor lesions in the airway, and the airway was severely narrowed, with about 90% obstruction.

Central airway stenosis refers to the narrowing or obstruction of the central airway such as the trachea and main bronchus caused by various causes, resulting in severe coughing, hemoptysis, and severe breathing difficulties.

Liu Jing and Deputy Chief Physician Tu Changli read the film and analyzed that the patient’s main airway is extremely narrow, which may cause suffocation at any time due to a cough or a mouthful of phlegm, which is life-threatening. Experts from thoracic surgery, ICU, radiology and other departments conducted multidisciplinary consultation and decided to perform partial tumor destruction under rigid bronchoscopy under general anesthesia, and prepare ECMO. Once ventilation is impossible, the operation can be completed with the assistance of ECMO.

This treatment method both anesthesia and surgery need to be performed in the patient’s airway, which requires extremely high perioperative management level of the anesthesiologist; airway collapse, massive hemoptysis, asphyxia, etc. may occur at any time during the operation. Happening.

The operation lasted for 1 hour. The surgical team successfully opened the airway and excised a tracheal tumor about 5×2cm in size. The tracheal intubation of the patient was removed within 24 hours after the operation, and the dyspnea was significantly relieved. The patient has now been transferred back to the general ward, and his condition has turned a corner.

Respiratory endoscopic airway tumor ablation is an important method for the treatment of airway lesions. It can quickly and effectively remove airway tumors, open the airway, and relieve symptoms such as dyspnea. There is an immediate effect. At present, the Fifth Hospital of CUHK routinely conducts rigid bronchoscopy treatment, including various cold and heat ablation, airway stent implantation and other technologies, to provide patients in Zhuhai and surrounding areas with higher quality and advanced medical services.

Source | Yangcheng Evening News ▪ Yangcheng Pie

Editor | Feng Xiaojing

Proofreading | Zhou Yong