Chest
Volume 94, Issue 3, September 1988, Pages 595-598
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Endobronchial Electrocautery

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Endobronchial electrocautery is a tool with diagnostic and therapeutic applications in the management of obstructing endobronchial disease. We have performed cautery procedures in 18 patients. Of these 18, five patients had benign diagnoses and 13 had malignancies. All patients with benign lesions had only endobronchial resections and four have done well. Four procedures resulted in the establishment of a diagnosis which had eluded other biopsy techniques. In 11 patients with malignant disease, electrocautery was used for palliation of airway obstruction, and in two patients, the snare was used as a biopsy technique. There have been no complications while utilizing the snare; however, application of electrocautery probes was associated with two complications. Our experience demonstrates the value and safety of using cautery wire snares to diagnose and treat endobronchial lesions. (Chest 1988; 94:595-98)

Section snippets

METHODS

Procedures were performed in the endoscopy laboratory. Anesthesia was primarily local, but in select cases, general anesthesia was used when an extremely large lesion was present, when the patient's clinical situation dictated careful airway control, or when a long procedure was anticipated.

All procedures performed were done with a fiberoptic bronchoscope. Intubation was carried out only in those patients who received general anesthesia. Patients were prepared with a cautery grounding plate

RESULTS

To date, we have performed 32 cautery procedures in 18 patients. Four patients and 15 procedures have previously been reported. Our experience is reported in Table 1. A majority of the patients underwent snare resection which was usually accomplished in one procedure. Four patients had two snare procedures each. The use of the cautery probe as a technique to destroy tissue was used in four patients, and two of those have been previously reported.

The diagnoses of the patients who underwent

DISCUSSION

This experience demonstrates the value and relative safety of using cautery wire snares to diagnose and treat endobronchial lesions. Endoscopic electrosurgical techniques have been used safely for removal of colonic polyps and for controlling gastrointestinal bleeding.2, 3, 4, 5 The electrocautery snare can be used to obtain large biopsies of airway lesions, to debulk and remove malignant tissue in the airway, and to treat benign lesions. Our experience supports all of these applications.

REFERENCES (5)

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Manuscript received August 27; revision accepted February 9.

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