Chest
BronchoscopyTissue Effects of Bronchoscopic Electrocautery
Section snippets
Materials and Methods
Six patients (two women and four men) with non-small cell lung cancer who were selected for pulmonary resection after clinical staging procedures including mediastinoscopy were treated with BE immediately before surgery, after general anesthesia and tracheal intubation had been performed. Informed consent was given by all prior to surgery. A fiberoptic bronchoscope with a flexible monopolar electrocautery probe (2-mm2 surface area; Olympus; Tokyo, Japan) was inserted through the tracheal tube.
Results
Bronchoscopic appearance of the BE lesion after a 1-s application revealed whitening of the mucosa with a small, well-defined lesion. Electrocautery after 2 s caused the same mucosal changes with some charring. Three- and 5-s applications showed deeper crater-shaped lesions with more profound charring (Fig 1 ). Examination of histologic changes showed crater-shaped appearance of the lesions containing varying quantities of coagulation necrosis. In some cases, the crater-shaped lesion was
Discussion
In this study, BE at a power setting of 30 W caused bronchial tissue destruction with an extent that varied with the duration of application. After short duration of electrocautery (1 s or 2 s), only superficial damage was found. After BE application of 3 s, damage extended as far as the underlying cartilage layer in most cases. After 5 s of application, cartilage damage was documented in almost every case. The voltage difference between probe and tissue, and the surface area of contact in this
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