الفهرس | Only 14 pages are availabe for public view |
Abstract Haemoptysis can be a life-threatening condition and its management has changed in the recent years due to technological advances. Bronchial artery embolization and improvements in CT are important landmarks. Bronchoscopy remains one of the main procedures in cases of haemoptysis. Beyond the diagnostic value, therapeutic techniques of interventional pulmonology can be useful in the bleeding management. Argon Plasma Coagulation is a type of electrosurgery, used to induce mostly superficial thermal effects on tissue in a non-contact manner. Electrosurgery is the application of an alternating current (AC) to a biological tissue in order to induce a thermal effect through heating to selectively destroy the tissue. Heating of a biological tissue can induce different effects which depend not only on the reached temperature, but also on the rate and duration of heating. For human tissue at temperatures below 40°C, no irreversible cellular damage occurs. Argon plasma coagulation (APC) is a thermal coagulation technique that uses ionized argon to transmit high-frequency electrical current. Argon Plasma Coagulation (APC) was first introduced in open surgery in the late 1970s and was adapted for use in endoscopy in 1991 then has become the most commonly used endoscopic coagulation technique especially for haemostasis of superficial bleeding. Argon-plasma coagulation is an electrosurgical noncontact thermal ablation technique based on transmission of a high-frequency voltage current through argon gas to result in thermal damage. It has been safely and efficaciously used in multiple settings The aim of this study was to evaluate the efficacy and safety of Argon Plasma Coagulation in the treatment of patients with haemoptysis in a purpose of using it at as an adjuvant tool that alleviates this risky presentation. This study was carried out on twenty patients referred to the Chest Department, Menoufia University hospital; the included patients were subjected to: 1. History taking. 2. Clinical evaluation. 3. Rotine laboratory investigations. 4. Radiological investigations. 5. Chest X-ray posterior-anterior views. 6. Computed tomography (CT) of the chest. 7. APC via fiberoptic bronchoscopy. In the study the mean age of the studied patients was (48±12) years. Sixty five percent of our patients were smokers, about 80% of patients were males. There were 3 patients without comorbidities (15%), thirteen patients with COPD (65%), one patient with HTN (5%), one patient with DM (5%) and two patients with HCV. Mild hemoptysis was present in 70% of patients while moderate hemoptysis was present in 30% of patients, no patient had severe hemoptysis. Also, dyspnea and cough were present in 85% of patients. After APC 45% of patients had no changes on C-T while 55% of patients had reduced size of the lesion after APC due to good haemostasis. All patients had haemoptysis they were managed by APC for haemostasis. Biopsies were taken from 18 patients (90%), debulking was done in 17 patients (85%). One patient (5%) was complicated by increased haemoptysis (just increased frequency) and two patients by increased dyspnoea. Three patients had mild sinus tachycardia (15%) and one patient had bronchospasm (relieved by bronchodilators and nebulizer). |