Novel Insights from Clinical Practice

Huang Z.-S.a· Xiang Q.a· Wu X.-L.a· Zhang A.-M.b· Liu S.-L.a· Wang J.a· Herth F.J.F.c· Fan Y.a

Author affiliations

aDepartment of Respiratory Disease, Xinqiao Hospital, Third Military Medical University, Chongqing, China
bDepartment of Oncology, Xinqiao Hospital, Third Military Medical University, Chongqing, China
cDepartment of Pneumology and Critical Care Medicine, Thoraxklinik, and Translational Lung Research Center Heidelberg, University of Heidelberg, Heidelberg, Germany

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Article / Publication Details

First-Page Preview

Received: April 26, 2022
Accepted: June 21, 2022
Published online: August 25, 2022

Number of Print Pages: 5
Number of Figures: 2
Number of Tables: 0

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: https://www.karger.com/RES

Abstract

Mediastinal abscess, mostly resulting from esophageal perforation or cardiothoracic surgery, is a serious condition carrying high morbidity and mortality. Antibiotic therapy alone normally did not achieve a satisfactory outcome, due to poor circulation of abscess that hampers drug delivery. Surgical intervention for debridement and drainage is recommended, but it poses a high risk in patients with poor health status and could lead to various complications. Recent studies proposed endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) as an effective alternative to surgery; however, repeated TBNA procedures are usually needed for complete clearance of the lesion, thus causing increased patient suffering and medical expenses. Here, we present the first case of successful application of EBUS-guided transbronchial incision and drainage, which provides a novel, safe, and effective treatment for patient with mediastinal abscess unwilling or unsuitable to undergo surgical intervention.

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References Gisasola P, Iriarte A, Larez MR, Casanova L, Bujanda L. Mediastinal abscess, an unusual way of presentation of eosinophilic esophagitis. Allergy Asthma Clin Immunol. 2019;15:12. Chen YF, Ho CC, Chen CY, Yu CJ. Endobronchial ultrasonographically guided transbronchial needle aspiration in mediastinal abscesses. J Thorac Cardiovasc Surg. 2013;145(6):e54–57. Casal RF, Jimenez CA, Mehran RJ, Eapen GA, Ost D, Sarkiss M, et al. Infected mediastinal bronchogenic cyst successfully treated by endobronchial ultrasound-guided fine-needle aspiration. Ann Thorac Surg. 2010;90(4):e52–53. Tian L, Krimsky WS, Wu Q, Sun J. Risks and benefits in treatment of mediastinal abscess by endobronchial ultrasound-guided transbronchial needle aspiration. Clin Respir J. 2017;11(4):448–52. Zuo T, Gong FY, Chen BJ, Ni ZY, Zhang DY. Video-assisted thoracoscopic surgery for the treatment of mediastinal lymph node tuberculous abscesses. J Huazhong Univ Sci Technolog Med Sci. 2017;37(6):849–54. Pretreatment evaluation of non-small-cell lung cancer. The American Thoracic Society and The European Respiratory Society. Am J Respir Crit Care Med. 1997;156:320–32. Detterbeck FC, Jantz MA, Wallace M, Vansteenkiste J, Silvestri GA; American College of Chest Physicians. Invasive mediastinal staging of lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007;132(3 Suppl):202S–220S. Fang Y, Cheng L, Guo J, Wu C, Gu Y, You X, et al. Application of endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis and treatment of mediastinal lymph node tuberculous abscess: a case report and literature review. J Cardiothorac Surg. 2020;15(1):331. Zhang J, Fu WL, Huang ZS, Guo JR, Li Q, Herth FJF, et al. Primary mediastinal seminoma achieved by transbronchial mediastinal cryobiopsy. Respiration. 2020;99(5):426–30. Zhang J, Guo JR, Huang ZS, Fu WL, Wu XL, Wu N, et al. Transbronchial mediastinal cryobiopsy in the diagnosis of mediastinal lesions: a randomised trial. Eur Respir J. 2021;58(6):2100055. Article / Publication Details

First-Page Preview

Received: April 26, 2022
Accepted: June 21, 2022
Published online: August 25, 2022

Number of Print Pages: 5
Number of Figures: 2
Number of Tables: 0

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: https://www.karger.com/RES

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