Abstract:

Objective To evaluate the efficacy of combined thermoablation and cryoablation treatment of lymph nodes fistula type of central airway tracheo-bronchial tuberculosis (TBTB) under flexible bronchoscopy (referred to as “bronchoscopy”).Methods A total of 78 patients with TBTB were enrolled in the Anhui Provincial Chest Hospital from January 2013 to January 2017. After approval by the Ethics Committee, 39 patients in the control group were treated with systemic anti-tuberculosis treatment and bronchoscopy which biopsy forceps were repeatedly cleaned and the isoniazid was injected through the catheter at the lesion. The observation group were treated with systemic anti-tuberculosis treatment and bronchoscopy which combined with cryo-thermo ablation and the isoniazid was injected through the catheter at the lesion. All of them were ended up with endoscopic treatment after stable lesions and followed up for 1 year. The average number of treatments was calculated, and the clinical symptoms and bronchoscopy findings were observed at 1, 3, 6, and 12 months after treatment, and the treatment efficiency was evaluated.Results The average number of interventional treatments in the observation group and the control group were (12.49±3.34) times and (17.28±3.64) times. The average number of treatments in the observation group was significantly lower than that in the control group. The difference was statistically significant (t=6.055, P<0.001); The effective rates of treatment in the observation group at 3 months, 6 months, and 12 months were 48.72% (19/39), 82.05% (32/39), and 92.31% (36/39) respectively, which were higher than that in the control group (20.51% (8/39), 53.85% (21/39), 71.79% (28/39)), the difference was statistically significant (χ ²=6.854, P=0.009; χ ²=7.123, P=0.008; χ ²=5.571, P=0.018). A total of 43 patients in the two groups were treated with a small amount of hemorrhage, which was improved after endoscopic spray of 1∶20000 adrenaline, ice physiological saline and Bothrops atrox hemocoagulase, and there were no serious complications such as major bleeding, perforation, and pneumothorax.Conclusion The combined thermoablation and cryoablation treatment of lymph nodes fistula type of central airway tracheo-bronchial tuberculosis under flexible bronchoscopy can reduce the average number of treatments and improve the patients’ treatment efficiency.

Key words: Ablation techniques, Bronchoscopy, Comparative effectiveness research, Lymph nodes fistula type, Bronchial tuberculosis