Camelia Badescu

Context: Endobronchial tumors are relatively rare. Pathological types are varied, both benign and malignant. Establishing the diagnosis and sleeve resection criteria for such tumors remains a challenge for pulmonologists, bronchoscopists, radiologists, thoracic surgeons, and pathologists. The management of the preoperative assessment of these patients and the establishment of the indication for sleeve resection, represent a big problem. Lung parenchymal sparing surgery remains a challenge, especially in neoplastic patients. Material and methods: We carried out a monocentric retrospective study, during the period 2009-2017, on a number of 57 patients. In our center they benefited from clinical examination, radiography, tomography, respiratory function evaluations, autofluorescence bronchoscopy, cardiological evaluation and detection of blood tumor markers. All the patients benefited from the analysis of the tumorboard of our institute and the establishment of the surgical indication for scleev resection. Results: Sparing of the lung parenchyma was achieved in case of the 57 patients included in the study. The complex evaluations of laboratory parameters, functional tests, CT examination, bronchoscopy, cardiology, were analyzed by the tumor board, so that the indication for surgical intervention was sleeve resection with preservation of the lung parenchyma. Conclusions: We selected patients for sleeve resection, those who presented endobronchial tumors of 2 cm in diameter, with cartilages and bronchial mucosa intact at least 1 cm or 2 cartilages from the formation, on CT and bronchoscopic examination. Cardiological examination and functional tests showed values that do not contradict surgical intervention.

Lung cancer (LC), is a disease who has increasing prevalence, with a major impact to morbidity and mortality but also significant consumption of resources. The incidence of LC cases is in progression and early diagnosis becomes extremely important in increasing the quality of life and survival. Detection of preneoplastic mucosal lesions can be performed with autofluorescence bronchoscopy (AF). This is not a new method of diagnosis being still in research for standardization and an applicability as easy as possible. AF should be used as a screening method in pacients with suspected LC.

Chronic obstructive pulmonary disease (COPD) and lung cancer (LC) occupy first place among diseases with high incidence and mortality and become a genuine health problem through costs for the medical system. COPD is considered an independent risk factor for LC, in addition to smoking and occupational exposure. Prevention policies and early diagnosis and treatment may contribute to the decrease in the incidence of both diseases. This article reviews the epidemiological overlaps between the two diseases and the particular features of the diagnosis and treatment of LC in COPD patients.