Tuberc Respir Dis.  1990 Mar;37(1):74-82. 10.4046/trd.1990.37.1.74.

Endobronchial Electrosurgery: Application of a Newly-designed Probe in Malignant Airway Obstruction

Abstract

There are two popular methods for endobronchial electrosurgery, namely, excision of tumors with a diathermic snare and electrodestruction of tumors with a cautery probe. But, it is nearly impossible to insert the diathermic snare under the tumor base when it is broad or when the bronchial lumen is tightly obstructed by the tumor, and electrodestruction requires longer time to ablate tumor tissue than Nd. YA G laser does. To supplement these weak points of electrosurgery, we designed a new electric probe shaped like a knife. Electrosurgery was performed in 10 patients with malignant airway obstruction by passing the bronchofiberscope via the intubation tube under local anesthesia, and clean-up bronchoscopy was done 3 to 5 days after electrosurgery. Of the ten patients, nine had primary lung cancer and one had endobronchial metastasis of renal çell carcinoma, and in 3 cases the histologic diagnosis was made after the procedure. Therapeutic results were excellent in five (50.0%), fair in four (40.0 %), and poor in one (10.0% ). 1n 4 cases, FEV1.0 increased two- or three-fold. Endobronchial electrosurgery was not accompanied by complications except transient fever in two of 10 patients. Endobronchial electrosurgery is a valuable tool with potential for the diagnosis and therapy of endobronchial obstructing airway lesion, and the newly-designed electric knife may be used not on ly to Cutaway polypoid lesion but also to destruct tumor tissue.

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