Endoscopic diagnosis and treatment of patients with tracheobronchial tree tumors

Introduction. The diagnosis and treatment of bronchial tumors remain one of the most challenging and relevant issues in modern medicine. Benign tumors with an endobronchial growth pattern are particularly alarming. These neoplasms are characterized by slow growth, an absence or scarcity of clinical symptoms until complications arise, and relatively rare malignant transformation.

Aim. To analyze the efficacy of diagnostic methods and endoscopic interventions aimed at restoring bronchial patency in patients with tumors of the bronchial tree.

Materials and methods. The study included 24 patients with tumors of the trachea and bronchi (20 (83 %) men and 4 (17 %) women) who received treatment at the N. N. Blokhin National Medical Research Center of Oncology from 2011 to July 2024. All patients underwent a comprehensive examination, which included standard blood tests, computed tomography of the thorax, and bronchoscopy with biopsy followed by morphological verification.

Results. Endoscopic examination using all available imaging modalities revealed bronchial lumen obstruction by exophytic masses of various shapes and consistencies, located on both broad and narrow bases. The tumor was localized in the trachea in 6 (25 %) cases and within the bronchial lumen in 18 (75 %) cases. Endoscopic tumor resection for diagnostic and treatment purposes was performed in all 24 (100 %) patients. Electrosurgery was performed using an endolaryngeal mask (7 (30 %) cases) and a rigid bronchoscope (15 (70 %) cases). As a result, bronchial patency was successfully restored without stenting. Adenoid cystic carcinoma was identified in 2 (8.3 %) patients, adenocarcinoma in 2 (8.3 %), and atypical carcinoid in 2 (8.3 %).

Conclusion. Endoscopic treatment methods, such as loop electrosurgical excision and its combination with electrocoagulation, are effective approaches for restoring bronchial patency in patients with benign tumors, as well as a way to obtain a substantial amount of tissue material to establish a diagnosis. The obtained data confirm the significance of endoscopic methods in the treatment of bronchial tumors.