Cryotherapy

Cryotherapy is a therapeutic bronchoscopic technique used to treat airway obstructions and tumors by applying extreme cold to targeted tissues. It is typically performed using a bronchoscope—a thin tube equipped with a camera—inserted through the nose or mouth into the airways.

With the help of this device, physicians like Dr. Manoj Kumar Goel can visualize internal structures of the airway and detect tumors, obstructions, or abnormal tissue. Once located, the doctor applies low-temperature cryotherapy or electric energy through a probe (cryoprobe) to destroy the mass, which is then extracted via the bronchoscope.

Possible Risks and Complications

While every effort is made to ensure patient safety and minimize discomfort, as with any procedure, bronchoscopy and cryotherapy carry potential risks. The overall complication rate for bronchoscopy is between 0.8% – 1.3%, while for cryotherapy or electrocautery, it's less than 6%.

Reported complications include:

• Air accumulation in the pleural space (pneumothorax)
• Bleeding (hemorrhage)
• Subcutaneous emphysema
• Post-procedure fever or infection
• Cardiac arrhythmias
• Hypoxemia (low oxygen)
• Vasovagal episodes, myocardial infarction
• Pulmonary edema, bronchospasm
• Airway perforation or tracheo-esophageal fistula

The mortality rate associated with bronchoscopy is very low at <0.01%. Cryotherapy is generally considered a safe diagnostic and therapeutic tool, even in high-risk cardiopulmonary patients.

According to Maiwand’s case series of 521 patients:

• 3% experienced temporary respiratory distress
• 1% in-hospital mortality (mainly due to respiratory failure)
• 2% developed arrhythmias
• Bleeding was mild in most cases, with >250ml blood loss reported in <5%

Post-Procedure Care

After cryotherapy, patients may require:

1. Oxygen supplementation, especially if sedated or with impaired lung function.
2. A chest X-ray to rule out pneumothorax or complications.
3. Monitoring for symptoms such as chest pain, breathlessness, haemoptysis, surgical emphysema, or excessive cough after transbronchial biopsy.
4. Refraining from driving, signing legal documents, or operating machinery for 24 hours post-sedation.
5. Having a responsible adult accompany and stay with them overnight—especially for elderly or higher-risk patients.