Skip to main content
PMC home page
Thorax logoLink to Thorax
. 1993 Nov;48(11):1156–1159. doi: 10.1136/thx.48.11.1156

Bronchoscopic diathermy resection and stent insertion: a cost effective treatment for tracheobronchial obstruction.

M Petrou 1, D Kaplan 1, P Goldstraw 1
PMCID: PMC464908  PMID: 8296261

Abstract

BACKGROUND--Major airways obstruction is a distressing cause of morbidity and mortality. For disease that is extensive and recurrent, there is a need for a safe and cost effective technique for palliation. METHODS--The results of 29 patients with tracheobronchial obstruction (24 malignant and five benign) treated by diathermy resection alone or in combination with endobronchial stenting have been reviewed. RESULTS--The major site of obstruction was the trachea in 14, main carina in seven, right main bronchus in six, and left main bronchus in two patients. Fifteen had received other forms of treatment beforehand including external radiotherapy, endoscopic dilatation, and laser resection (Nd:YAG). Five patients required two or more treatment sessions for symptom recurrence. Ten patients also received additional treatment with a stent (nine) or insertion of gold grains (one). There were no intraoperative deaths or complications and the average length of stay was five days (range 2-14). Twenty eight patients reported immediate symptomatic relief, and objective improvement in the results of lung function tests was seen in eight patients whose condition was less acute and where preoperative lung function tests could be undertaken (average improvement in FEV1 of 53.1% and in FVC of 20.6%). CONCLUSIONS--Bronchoscopic diathermy resection is an effective and safe method for relieving the symptoms of tracheobronchial obstruction at appreciably less cost than laser resection.

Full text

PDF

Images in this article

1157Image
on p.1157
1157Image
on p.1157

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brutinel W. M., Cortese D. A., McDougall J. C., Gillio R. G., Bergstralh E. J. A two-year experience with the neodymium-YAG laser in endobronchial obstruction. Chest. 1987 Feb;91(2):159–165. doi: 10.1378/chest.91.2.159. [DOI] [PubMed] [Google Scholar]
  2. Cavaliere S., Foccoli P., Farina P. L. Nd:YAG laser bronchoscopy. A five-year experience with 1,396 applications in 1,000 patients. Chest. 1988 Jul;94(1):15–21. doi: 10.1378/chest.94.1.15. [DOI] [PubMed] [Google Scholar]
  3. George P. J., Garrett C. P., Hetzel M. R. Role of the neodymium YAG laser in the management of tracheal tumours. Thorax. 1987 Jun;42(6):440–444. doi: 10.1136/thx.42.6.440. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. George P. J., Irving J. D., Mantell B. S., Rudd R. M. Covered expandable metal stent for recurrent tracheal obstruction. Lancet. 1990 Mar 10;335(8689):582–584. doi: 10.1016/0140-6736(90)90358-c. [DOI] [PubMed] [Google Scholar]
  5. Hetzel M. R., Nixon C., Edmondstone W. M., Mitchell D. M., Millard F. J., Nanson E. M., Woodcock A. A., Bridges C. E., Humberstone A. M. Laser therapy in 100 tracheobronchial tumours. Thorax. 1985 May;40(5):341–345. doi: 10.1136/thx.40.5.341. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Ledingham S. J., Goldstraw P. Diathermy resection and radioactive gold grains for palliation of obstruction due to recurrence of bronchial carcinoma after external irradiation. Thorax. 1989 Jan;44(1):48–51. doi: 10.1136/thx.44.1.48. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Macha H. N., Koch K., Stadler M., Schumacher W., Krumhaar D. New technique for treating occlusive and stenosing tumours of the trachea and main bronchi: endobronchial irradiation by high dose iridium-192 combined with laser canalisation. Thorax. 1987 Jul;42(7):511–515. doi: 10.1136/thx.42.7.511. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Mathisen D. J., Grillo H. C. Endoscopic relief of malignant airway obstruction. Ann Thorac Surg. 1989 Oct;48(4):469–475. doi: 10.1016/s0003-4975(10)66842-7. [DOI] [PubMed] [Google Scholar]
  9. Rostom A. Y., Morgan R. L. Results of treating primary tumours of the trachea by irradiation. Thorax. 1978 Jun;33(3):387–393. doi: 10.1136/thx.33.3.387. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Tsang V., Goldstraw P. Endobronchial stenting for anastomotic stenosis after sleeve resection. Ann Thorac Surg. 1989 Oct;48(4):568–571. doi: 10.1016/s0003-4975(10)66865-8. [DOI] [PubMed] [Google Scholar]
  11. Tsang V., Williams A. M., Goldstraw P. Sequential silastic and expandable metal stenting for tracheobronchial strictures. Ann Thorac Surg. 1992 May;53(5):856–860. doi: 10.1016/0003-4975(92)91451-e. [DOI] [PubMed] [Google Scholar]
  12. Walsh D. A., Maiwand M. O., Nath A. R., Lockwood P., Lloyd M. H., Saab M. Bronchoscopic cryotherapy for advanced bronchial carcinoma. Thorax. 1990 Jul;45(7):509–513. doi: 10.1136/thx.45.7.509. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES