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.
Bronchoscopy unit of a university hospital.
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
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.