Bronchoscopic Management of Malignant Airway Disease

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Abstract
A wide variety of bronchoscopic modalities are currently available for management of patients with malignant airway disease. Knowledge of the strengths and limitations of these procedures will allow the selection of the most appropriate procedure for each specific patient and each specific airway lesion. Neodymi-um-yttrium-aluminum-garnet laser therapy is the most widely studied and used procedure. It produces immediate results in patients with exophytic endobronchial lesions, but it is not useful for extrinsic compression. Brachytherapy gives delayed results but has the advantage of treating submucosal and peribronchial disease. Endobronchial stents are especially useful in extrinsic compression, but the devices lack standardization and outcome studies. Cryotherapy is an inexpensive alternative to laser therapy but cannot be used in patients who require immediate palliation. Photodynamic therapy and endobronchial electrosurgery are still in the experimental stages. The final procedure choice should be based on the clinical presentation of the patient, the type and location of the lesion, and the experience and skill of the bron-choscopist

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