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Bronchoscopy |

Tissue Effects of Bronchoscopic Electrocautery*: Bronchoscopic Appearance and Histologic Changes of Bronchial Wall After Electrocautery

Ton J. M. van Boxem, MD; Johan Westerga, MD, PhD; Ben J. W. Venmans, MD; Pieter E. Postmus, MD, FCCP; Tom G. Sutedja, MD, PhD, FCCP
Author and Funding Information

*From the Departments of Pulmonary Medicine (Drs. Van Boxem, Venmans, Postmus, and Sutedja) and Pathology (Dr. Westerga), University Hospital Vrije Universiteit Amsterdam, the Netherlands.

Correspondence to: Tom G. Sutedja, MD, PhD, FCCP, Department of Pulmonary Medicine, University Hospital Vrije Universiteit Amsterdam, PO Box 7057, 1007 MB Amsterdam, the Netherlands; e-mail: tg.sutedja@azvu.nl



Chest. 2000;117(3):887-891. doi:10.1378/chest.117.3.887
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Study objectives: To study tissue effects of bronchoscopic electrocautery (BE).

Design: In six patients with non-small cell lung cancer, a BE procedure was performed immediately before surgery. After patients were placed on ventilation, normal mucosa on different carinae was treated with a cautery probe (2-mm2 surface area) at a power setting of 30 W with a variable time of application of 1 to 5 s. Bronchoscopic appearance of the treated area was documented photographically, and histologic changes of the bronchial wall were examined.

Setting: Bronchoscopy unit of a university hospital.

Measurements and results: BE resulted bronchoscopically in whitening of the bronchial mucosa with crater-shaped lesions. After longer duration of BE application, deeper craters with more profound charring were seen. Histologic changes of the lesions showed craters containing a variable amount of necrotic tissue. In one case, thin subsegmental carinae were coagulated and measurements could not be performed. In the remaining five cases, microscopic findings revealed 0.2 ± 0.1-mm necrosis after 1 s; 0.4 ± 0.2-mm necrosis after 2 s; 0.9 ± 0.5-mm necrosis after 3 s; and 1.9 ± 0.8-mm necrosis after 5 s. A variable degree of tissue damage surrounding the necrotic tissue area was found. In one case, cartilage damage appeared after 3 s of coagulation, and extensive damage of the underlying cartilage was seen in four cases after 5 s of application.

Conclusions: Superficial damage was obtained by short duration of BE (≤ 2 s), and longer duration of coagulation (3 s or 5 s) caused damage to the underlying cartilage. Bronchoscopic appearance after endobronchial electrocautery corresponded with the histologic changes.

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