الفهرس 
AIM OF THE WORKOnly 14 pages are availabe for public view
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Abstract
Introduction: Lung cancer is a leading cause of cancer-related mortality in both men and women throughout the world. Cigarette smoking is considered a single etiologic agent and by far the leading cause of lung cancer, accounting for approximately 90% of lung cancer cases. Approximately 75% of patients with lung cancer will have locally advanced or metastatic disease at the time of diagnosis and it has been estimated that about 30% of patients will develop obstruction of the airways at some point in their disease and that about 30% will die from pulmonary complications such as hypoxemia, hemoptysis or postobstructive pneumonia. Direct visualization by bronchoscopy can reveal the nature and extent of the airway obstruction, as well as providing useful information for planning treatment. Advances in bronchoscopic tools and techniques have provided interventional pulmonologists with a wide array of therapeutic options that can be used individually or in combination to match the needs of all patients. Laser therapy, electrocautery, argon plasma coagulastion, cryotherapy, stenting, bronchoscopic brachytherapy, bronchoscopic microdebrider, bronchoscopic intratumoral chemotherapy, photodynamic therapy, bronchscopic balloon dilation and endobronchial gene therapy are well-described techniques for the palliation of symptoms due to airway involvement in patients with advanced stages. This variety of interventional bronchoscopic techniques combined with surgery, external beam radiation, or chemotherapy form the cornerstone of treatment for endobronchial malignancies. It is well proven now that restoring central airway patency has a significant impact on symptoms, pulmonary function, quality of life, and in selected patients even on survival.
Aim of work: The aim of the work is to study the various modalities of interventional bronchoscopy used in management of malignant airway obstruction, their effects, safety and complications.
Conclusions: The most critical role of the pulmonologist in management of lung cancer is diagnosis and staging. Accurate staging dictates the patient’s treatment options and predicts survival. Smoking cessation has great benefit to reduce the incidence of lung cancer. Cryotherapy, brachytherapy and PDT are valuable when there is no emergency need of relieving airway obstruction. Laser, EC, APC and microdebrider can be used for immediate relief of symptomatic malignant airway obstruction. Electrocautary and APC are considered as poor man laser with an immediate effect and reduced cost. Bronchoscopic gene therapy is a new hope in management of malignant airway obstruction.