Hemoptysis surgery: Difference between revisions

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==Overview==
==Overview==


Massive hemoptysis is a life-threatening condition and requires prompt [[intensive care]]. Surgery is indicated in patients with hemoptysis who are resistant to [[Therapeutic embolization|embolization]]. Interventional techniques are used to stop [[bleeding]] which include bronchial arterial [[Therapeutic embolization|embolization]], different [[Bronchoscopy|bronchoscopic]] strategies such as cold [[Saline (medicine)|saline]] lavage, topical [[vasoconstrictor]] agents, [[balloon tamponade]], endobronchial [[stent]] placement, endobronchial spigot, oxidized regenerated [[cellulose]], [[Cyanoacrylate|N-Butyl cyanoacrylate glue]], [[fibrinogen]] [[thrombin]], [[tranexamic acid]], [[laser photocoagulation]], [[argon plasma coagulation]], and [[Cauterization|electrocautery]]. Surgical techniques that are used for management of hemoptysis include [[Pneumonectomy|pulmonary resection]], [[lobectomy]], and bilobectomy. Surgical techniques are definitely curative, effective for localized lesions. However, surgery has a [[mortality rate]] of 10-30%. Currently, bronchial arterial [[Therapeutic embolization|embolization]] considered as a first line therapy for both new and recurrent hemoptysis.
==Indications==
*[[Surgery|Surgical]] intervention is recommended for the management of massive hemoptysis.<ref name="pmid12400152">{{cite journal |vauthors=Johnson JL |title=Manifestations of hemoptysis. How to manage minor, moderate, and massive bleeding |journal=Postgrad Med |volume=112 |issue=4 |pages=101–6, 108–9, 113 |year=2002 |pmid=12400152 |doi= |url=}}</ref>
*Massive hemoptysis is a life-threatening condition and requires prompt [[intensive care]].<ref name="pmid20043609">{{cite journal |vauthors=Dudha M, Lehrman S, Aronow WS, Rosa J |title=Hemoptysis: diagnosis and treatment |journal=Compr Ther |volume=35 |issue=3-4 |pages=139–49 |year=2009 |pmid=20043609 |doi= |url=}}</ref><ref name="pmid21442867">{{cite journal |vauthors=Liippo K, Vasankari T |title=[Hemoptysis] |language=Finnish |journal=Duodecim |volume=127 |issue=2 |pages=178–84 |year=2011 |pmid=21442867 |doi= |url=}}</ref>
*Surgery is indicated in patients with hemoptysis who are resistant to [[Therapeutic embolization|embolization]], such as:
**[[Aspergillosis|Aspergilloma]]
**[[Echinococcosis|Hydatid cyst]]
**[[Chest|Thoracic]] [[vascular injury]]
**[[Bronchial]] [[adenoma]]


==Indications==
==Interventional Procedures==
*Surgical intervention is recommended for the management of massive hemoptysis.<ref name="pmid12400152">{{cite journal |vauthors=Johnson JL |title=Manifestations of hemoptysis. How to manage minor, moderate, and massive bleeding |journal=Postgrad Med |volume=112 |issue=4 |pages=101–6, 108–9, 113 |year=2002 |pmid=12400152 |doi= |url=}}</ref>
*Interventional techniques are used to stop [[bleeding]] which include:<ref name="pmid12816036">{{cite journal |vauthors=Mal H, Thabut G, Plantier L |title=[Hemoptysis] |language=French |journal=Rev Prat |volume=53 |issue=9 |pages=975–9 |year=2003 |pmid=12816036 |doi= |url=}}</ref><ref name="pmid10205720">{{cite journal |vauthors=Dweik RA, Stoller JK |title=Role of bronchoscopy in massive hemoptysis |journal=Clin. Chest Med. |volume=20 |issue=1 |pages=89–105 |year=1999 |pmid=10205720 |doi= |url=}}</ref><ref name="pmid22420099">{{cite journal |vauthors=Joskin J, Bruls S, Brisbois D |title=[Bronchial artery ligation for the management of hemoptysis] |language=French |journal=Rev Med Liege |volume=67 |issue=1 |pages=21–5 |year=2012 |pmid=22420099 |doi= |url=}}</ref><ref name="pmid20090288">{{cite journal |vauthors=Sakr L, Dutau H |title=Massive hemoptysis: an update on the role of bronchoscopy in diagnosis and management |journal=Respiration |volume=80 |issue=1 |pages=38–58 |year=2010 |pmid=20090288 |doi=10.1159/000274492 |url=}}</ref><ref name="pmid23463474">{{cite journal |vauthors=Darwiche K, Karpf-Wissel R, Freitag L |title=[Hemoptysis--targets in diagnostic and therapy] |language=German |journal=Dtsch. Med. Wochenschr. |volume=138 |issue=11 |pages=530–5 |year=2013 |pmid=23463474 |doi=10.1055/s-0032-1332907 |url=}}</ref>
*Massive hemoptysis is a life-threatening condition and requires prompt intensive care.<ref name="pmid20043609">{{cite journal |vauthors=Dudha M, Lehrman S, Aronow WS, Rosa J |title=Hemoptysis: diagnosis and treatment |journal=Compr Ther |volume=35 |issue=3-4 |pages=139–49 |year=2009 |pmid=20043609 |doi= |url=}}</ref>
**[[Bronchial artery|Bronchial arterial]] [[Therapeutic embolization|embolization]] which is:<ref name="pmid17018424">{{cite journal |vauthors=Andersen PE |title=Imaging and interventional radiological treatment of hemoptysis |journal=Acta Radiol |volume=47 |issue=8 |pages=780–92 |year=2006 |pmid=17018424 |doi=10.1080/02841850600827577 |url=}}</ref><ref name="pmid26293972">{{cite journal |vauthors=Ramírez Mejía AR, Méndez Montero JV, Vásquez-Caicedo ML, Bustos García de Castro A, Cabeza Martínez B, Ferreirós Domínguez J |title=Radiological Evaluation and Endovascular Treatment of Hemoptysis |journal=Curr Probl Diagn Radiol |volume=45 |issue=3 |pages=215–24 |year=2016 |pmid=26293972 |doi=10.1067/j.cpradiol.2015.07.007 |url=}}</ref><ref name="pmid28213604">{{cite journal |vauthors=Ishikawa H, Hara M, Ryuge M, Takafuji J, Youmoto M, Akira M, Nagasaka Y, Kabata D, Yamamoto K, Shintani A |title=Efficacy and safety of super selective bronchial artery coil embolisation for haemoptysis: a single-centre retrospective observational study |journal=BMJ Open |volume=7 |issue=2 |pages=e014805 |year=2017 |pmid=28213604 |pmc=5318547 |doi=10.1136/bmjopen-2016-014805 |url=}}</ref><ref name="pmid25372159">{{cite journal |vauthors=Ittrich H, Klose H, Adam G |title=Radiologic management of haemoptysis: diagnostic and interventional bronchial arterial embolisation |journal=Rofo |volume=187 |issue=4 |pages=248–59 |year=2015 |pmid=25372159 |doi=10.1055/s-0034-1385457 |url=}}</ref><ref name="pmid15916059">{{cite journal |vauthors=Reechaipichitkul W, Latong S |title=Etiology and treatment outcomes of massive hemoptysis |journal=Southeast Asian J. Trop. Med. Public Health |volume=36 |issue=2 |pages=474–80 |year=2005 |pmid=15916059 |doi= |url=}}</ref><ref name="ShigemuraWan2009">{{cite journal|last1=Shigemura|first1=Norihisa|last2=Wan|first2=Innes Y.|last3=Yu|first3=Simon C.H.|last4=Wong|first4=Randolph H.|last5=Hsin|first5=Michael K.Y.|last6=Thung|first6=Hoi K.|last7=Lee|first7=Tak-Wai|last8=Wan|first8=Song|last9=Underwood|first9=Malcolm J.|last10=Yim|first10=Anthony P.C.|title=Multidisciplinary Management of Life-Threatening Massive Hemoptysis: A 10-Year Experience|journal=The Annals of Thoracic Surgery|volume=87|issue=3|year=2009|pages=849–853|issn=00034975|doi=10.1016/j.athoracsur.2008.11.010}}</ref><ref name="NoëJaffé2011">{{cite journal|last1=Noë|first1=G.D.|last2=Jaffé|first2=S.M.|last3=Molan|first3=M.P.|title=CT and CT angiography in massive haemoptysis with emphasis on pre-embolization assessment|journal=Clinical Radiology|volume=66|issue=9|year=2011|pages=869–875|issn=00099260|doi=10.1016/j.crad.2011.03.001}}</ref>
==Contraindications==
***Considered as a first line therapy for both new and recurrent hemoptysis
***Less [[Invasive (medical)|invasive]] and reliable procedure
***Operator-dependent technique
***Excellent outcome with immediate control of [[bleeding]] reaching 80-94%
{{#ev:youtube|kLO6UXaVb9w}}
{{#ev:youtube|zJ85gIjGOzY}}
* Other [[Bronchoscopy|bronchoscopic]] strategies that are used to stop [[bleeding]] in a patient with hemoptysis include:
** Cold [[Saline (medicine)|saline]] lavage
** Topical [[vasoconstrictor]] agents
** [[Balloon tamponade]]
** Endobronchial [[stent]] placement
** Endobronchial spigot
** Oxidized regenerated [[cellulose]]
** [[Cyanoacrylate|N-Butyl cyanoacrylate glue]]
** [[Fibrinogen]] [[thrombin]]
** [[Tranexamic acid]]
** [[Laser photocoagulation]]
** [[Argon plasma coagulation]]
** [[Cauterization|Electrocautery]]


==Surgery==
== Surgery ==
*Patients with massive hemoptysis must be admitted in the ICU and prompt surgical and medical interventions must be started.<ref name="pmid12400152">{{cite journal |vauthors=Johnson JL |title=Manifestations of hemoptysis. How to manage minor, moderate, and massive bleeding |journal=Postgrad Med |volume=112 |issue=4 |pages=101–6, 108–9, 113 |year=2002 |pmid=12400152 |doi= |url=}}</ref>
*Patients with massive hemoptysis must be admitted in the [[Intensive care unit|ICU]] and prompt surgical and medical interventions must be started.<ref name="pmid12400152" />
*An appropriate team of cardiothoracic surgery, pulmonary medicine, anesthesia, and interventional radiology is required to manage the massive hemoptysis.<ref name="pmid12793622">{{cite journal |vauthors=Corder R |title=Hemoptysis |journal=Emerg. Med. Clin. North Am. |volume=21 |issue=2 |pages=421–35 |year=2003 |pmid=12793622 |doi= |url=}}</ref>
*An appropriate team of [[Cardiac surgery|cardiothoracic]] surgery, [[Lung|pulmonary]] medicine, [[anesthesia]], and [[interventional radiology]] is required to manage the massive hemoptysis.<ref name="pmid12793622">{{cite journal |vauthors=Corder R |title=Hemoptysis |journal=Emerg. Med. Clin. North Am. |volume=21 |issue=2 |pages=421–35 |year=2003 |pmid=12793622 |doi= |url=}}</ref><ref name="pmid20090288" /><ref name="pmid16739895">{{cite journal |vauthors=Schwizer B |title=[Acute hemoptysis] |language=German |journal=Ther Umsch |volume=63 |issue=5 |pages=355–9 |year=2006 |pmid=16739895 |doi=10.1024/0040-5930.63.5.355 |url=}}</ref>
*Different techniques that are used to stop bleeding, include:<ref name="pmid12816036">{{cite journal |vauthors=Mal H, Thabut G, Plantier L |title=[Hemoptysis] |language=French |journal=Rev Prat |volume=53 |issue=9 |pages=975–9 |year=2003 |pmid=12816036 |doi= |url=}}</ref><ref name="pmid10205720">{{cite journal |vauthors=Dweik RA, Stoller JK |title=Role of bronchoscopy in massive hemoptysis |journal=Clin. Chest Med. |volume=20 |issue=1 |pages=89–105 |year=1999 |pmid=10205720 |doi= |url=}}</ref>
*[[Surgery]] was a first line therapy for massive hemoptysis in the past.
**Bronchial arterial embolization
*After introduction of bronchial arterial [[Therapeutic embolization|embolization]] in the 1970s, approaches toward massive hemoptysis were changed.
**Bronchoscopic balloon tamponade
*Surgical techniques that are used for management of hemoptysis include:
**[[Pneumonectomy|Pulmonary resection]]:<ref name="ShigemuraWan2009">{{cite journal|last1=Shigemura|first1=Norihisa|last2=Wan|first2=Innes Y.|last3=Yu|first3=Simon C.H.|last4=Wong|first4=Randolph H.|last5=Hsin|first5=Michael K.Y.|last6=Thung|first6=Hoi K.|last7=Lee|first7=Tak-Wai|last8=Wan|first8=Song|last9=Underwood|first9=Malcolm J.|last10=Yim|first10=Anthony P.C.|title=Multidisciplinary Management of Life-Threatening Massive Hemoptysis: A 10-Year Experience|journal=The Annals of Thoracic Surgery|volume=87|issue=3|year=2009|pages=849–853|issn=00034975|doi=10.1016/j.athoracsur.2008.11.010}}</ref>
***It is definitely curative.
***It is effective for localized lesions.
***It has a [[mortality rate]] of 10-30%.
***[[Bronchoscopy|Rigid bronchoscopy]] procedure before [[surgery]] improves the outcome by clearing the [[airway]] and stabilizing patients in emergency situations.
{{#ev:youtube|8c8j_yYavMI}}
*Other techniques that are used to manage hemoptysis include:<ref name="ShigemuraWan2009">{{cite journal|last1=Shigemura|first1=Norihisa|last2=Wan|first2=Innes Y.|last3=Yu|first3=Simon C.H.|last4=Wong|first4=Randolph H.|last5=Hsin|first5=Michael K.Y.|last6=Thung|first6=Hoi K.|last7=Lee|first7=Tak-Wai|last8=Wan|first8=Song|last9=Underwood|first9=Malcolm J.|last10=Yim|first10=Anthony P.C.|title=Multidisciplinary Management of Life-Threatening Massive Hemoptysis: A 10-Year Experience|journal=The Annals of Thoracic Surgery|volume=87|issue=3|year=2009|pages=849–853|issn=00034975|doi=10.1016/j.athoracsur.2008.11.010}}</ref>
**[[Lobectomy]]
**Bilobectomy


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Medicine]]
[[Category:Gastroenterology]]
[[Category:Up-To-Date]]
[[Category:Surgery]]
[[Category:Emergency medicine]]

Latest revision as of 22:03, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]

Overview

Massive hemoptysis is a life-threatening condition and requires prompt intensive care. Surgery is indicated in patients with hemoptysis who are resistant to embolization. Interventional techniques are used to stop bleeding which include bronchial arterial embolization, different bronchoscopic strategies such as cold saline lavage, topical vasoconstrictor agents, balloon tamponade, endobronchial stent placement, endobronchial spigot, oxidized regenerated cellulose, N-Butyl cyanoacrylate glue, fibrinogen thrombin, tranexamic acid, laser photocoagulation, argon plasma coagulation, and electrocautery. Surgical techniques that are used for management of hemoptysis include pulmonary resection, lobectomy, and bilobectomy. Surgical techniques are definitely curative, effective for localized lesions. However, surgery has a mortality rate of 10-30%. Currently, bronchial arterial embolization considered as a first line therapy for both new and recurrent hemoptysis.

Indications

Interventional Procedures

{{#ev:youtube|kLO6UXaVb9w}} {{#ev:youtube|zJ85gIjGOzY}}

Surgery

  • Patients with massive hemoptysis must be admitted in the ICU and prompt surgical and medical interventions must be started.[1]
  • An appropriate team of cardiothoracic surgery, pulmonary medicine, anesthesia, and interventional radiology is required to manage the massive hemoptysis.[16][7][17]
  • Surgery was a first line therapy for massive hemoptysis in the past.
  • After introduction of bronchial arterial embolization in the 1970s, approaches toward massive hemoptysis were changed.
  • Surgical techniques that are used for management of hemoptysis include:

{{#ev:youtube|8c8j_yYavMI}}

  • Other techniques that are used to manage hemoptysis include:[14]

References

  1. ↑ 1.0 1.1 Johnson JL (2002). "Manifestations of hemoptysis. How to manage minor, moderate, and massive bleeding". Postgrad Med. 112 (4): 101–6, 108–9, 113. PMID 12400152.
  2. ↑ Dudha M, Lehrman S, Aronow WS, Rosa J (2009). "Hemoptysis: diagnosis and treatment". Compr Ther. 35 (3–4): 139–49. PMID 20043609.
  3. ↑ Liippo K, Vasankari T (2011). "[Hemoptysis]". Duodecim (in Finnish). 127 (2): 178–84. PMID 21442867.
  4. ↑ Mal H, Thabut G, Plantier L (2003). "[Hemoptysis]". Rev Prat (in French). 53 (9): 975–9. PMID 12816036.
  5. ↑ Dweik RA, Stoller JK (1999). "Role of bronchoscopy in massive hemoptysis". Clin. Chest Med. 20 (1): 89–105. PMID 10205720.
  6. ↑ Joskin J, Bruls S, Brisbois D (2012). "[Bronchial artery ligation for the management of hemoptysis]". Rev Med Liege (in French). 67 (1): 21–5. PMID 22420099.
  7. ↑ 7.0 7.1 Sakr L, Dutau H (2010). "Massive hemoptysis: an update on the role of bronchoscopy in diagnosis and management". Respiration. 80 (1): 38–58. doi:10.1159/000274492. PMID 20090288.
  8. ↑ Darwiche K, Karpf-Wissel R, Freitag L (2013). "[Hemoptysis--targets in diagnostic and therapy]". Dtsch. Med. Wochenschr. (in German). 138 (11): 530–5. doi:10.1055/s-0032-1332907. PMID 23463474.
  9. ↑ Andersen PE (2006). "Imaging and interventional radiological treatment of hemoptysis". Acta Radiol. 47 (8): 780–92. doi:10.1080/02841850600827577. PMID 17018424.
  10. ↑ Ramírez Mejía AR, Méndez Montero JV, Vásquez-Caicedo ML, Bustos García de Castro A, Cabeza Martínez B, Ferreirós Domínguez J (2016). "Radiological Evaluation and Endovascular Treatment of Hemoptysis". Curr Probl Diagn Radiol. 45 (3): 215–24. doi:10.1067/j.cpradiol.2015.07.007. PMID 26293972.
  11. ↑ Ishikawa H, Hara M, Ryuge M, Takafuji J, Youmoto M, Akira M, Nagasaka Y, Kabata D, Yamamoto K, Shintani A (2017). "Efficacy and safety of super selective bronchial artery coil embolisation for haemoptysis: a single-centre retrospective observational study". BMJ Open. 7 (2): e014805. doi:10.1136/bmjopen-2016-014805. PMC 5318547. PMID 28213604.
  12. ↑ Ittrich H, Klose H, Adam G (2015). "Radiologic management of haemoptysis: diagnostic and interventional bronchial arterial embolisation". Rofo. 187 (4): 248–59. doi:10.1055/s-0034-1385457. PMID 25372159.
  13. ↑ Reechaipichitkul W, Latong S (2005). "Etiology and treatment outcomes of massive hemoptysis". Southeast Asian J. Trop. Med. Public Health. 36 (2): 474–80. PMID 15916059.
  14. ↑ 14.0 14.1 14.2 Shigemura, Norihisa; Wan, Innes Y.; Yu, Simon C.H.; Wong, Randolph H.; Hsin, Michael K.Y.; Thung, Hoi K.; Lee, Tak-Wai; Wan, Song; Underwood, Malcolm J.; Yim, Anthony P.C. (2009). "Multidisciplinary Management of Life-Threatening Massive Hemoptysis: A 10-Year Experience". The Annals of Thoracic Surgery. 87 (3): 849–853. doi:10.1016/j.athoracsur.2008.11.010. ISSN 0003-4975.
  15. ↑ Noë, G.D.; Jaffé, S.M.; Molan, M.P. (2011). "CT and CT angiography in massive haemoptysis with emphasis on pre-embolization assessment". Clinical Radiology. 66 (9): 869–875. doi:10.1016/j.crad.2011.03.001. ISSN 0009-9260.
  16. ↑ Corder R (2003). "Hemoptysis". Emerg. Med. Clin. North Am. 21 (2): 421–35. PMID 12793622.
  17. ↑ Schwizer B (2006). "[Acute hemoptysis]". Ther Umsch (in German). 63 (5): 355–9. doi:10.1024/0040-5930.63.5.355. PMID 16739895.
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