Safety Study of Endobronchial Electrosurgery for Tracheobronchial Lesions: Multicenter Prospective Study


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Abstract

BackgroundSymptomatic stenosis of the airway necessitates intervention to keep the patency of tracheobronchial tree. Urgent treatment to secure the airway is therefore often required. Although endobronchial electrosurgery, defined as the interventional use of high-frequency electrical current under bronchoscopic guidance, has been used by many bronchoscopists, the safety of exposing the tracheobronchial tree to high-frequency electrical current remains to be established. This study was performed to establish the safe procedure of endobronchial electrosurgery for the effective treatment of tracheobronchial lesions.ObjectiveThis study was designed as prospective observational study to establish the safety usage of electrocautery in interventional bronchoscopy. Effects and adverse event was recorded and analyzed later.Patients and MethodsThirty-seven patients (31 males and 6 females, age 16 to 83 y, mean age 58 y) who had various tracheobronchial lesions underwent endobronchial electrosurgery. Endobronchial electrosurgery was performed with the use of endobronchial devices specially designed for bronchoscopy.ResultsNo major complication occurred. Among the 37 patients enrolled, the outcome of endobronchial electrosurgery was good in 35 and poor in 2. One of the patients with an unsatisfactory outcome had an intrabronchial polyp that contained calcified components; its hard consistency precluded snare resection. In the other, oozing bleeding from an intratracheal metastasis could not be completely controlled.ConclusionsEndobronchial electrosurgery is a safe, reliable procedure when used according to strict guidelines. The most promising indications are polypoid lesions of either granulomatous or malignant origin. The recommended power output is 20 to 30 W, and duration of electrocautery is less than 5 s per pulse.

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