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Pulmonary Procedures |

The Role of Endobronchial Electrocautery in Management of Airways Tumors

Ruxandra Ulmeanu, PhD; Ramona Nedelcu, MD; Dan Ioan Ulmeanu, PhD; Florin Dumitru Mihaltan, PhD
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Marius Nasta Institute of Pneumology, Bucharest, Romania


Chest. 2015;148(4_MeetingAbstracts):806A. doi:10.1378/chest.2277846
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Abstract

SESSION TITLE: Interventional Pulmonology Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: To demonstrate the practical value of endobronchial electrocautery - an excellent method with virtues of diagnosis with curative or palliative treatment in the management of obstructing endobronchial tumors.

METHODS: We present a practical review for endoscopically diagnosis and treatment of 16 cases of tumors located in the large airways, between 2006-2013 in the "Marius Nasta" Institute, Bucharest.

RESULTS: We used rigid bronchoscopy with jet ventilation. The fibrobronchoscope was inserted through the rigid bronchoscope for maneuvers of electrocautery. We performed endoscopic cauterization maneuvers using cautery wire snares for 6 benign conditions and 10 malignant tumors whose etiology was as follows: 8 metastases of nonsmall cell lung cancer (adenocarcinoma, squamous cell carcinoma) 1 hemangiopericytoma of left main bronchus 1 tracheal metastasis of thyroid cancer 1 tracheal hemangioma 4 lipomas (3 tracheal and 2 left main bronchus) 1 tracheal polyp Technique used was resection loop (lasso technique) for tumor, then electrode resection for tumor base. For 10 patients with malignant tumors technique was used for palliative purpose for severe obstruction of large airways (several sessions). All patients with benign tumors needed only a single endoscopic procedure. There were no anesthetics or major complications of endoscopic resection; only reduced bleeding for the malignant disorder (below 15-20 ml).

CONCLUSIONS: Obstructive tumors of large airways is a permanent challenge for the practitioner. Our experience argue for great safety and effectiveness for diagnosis and treatment of endobronchial wire snare electrocautery for these disorders.

CLINICAL IMPLICATIONS: Electrocautery has been used for treating benign and malignant disease, with both curative and palliative intent. Endobronchial interventions are important adjuncts in the multimodality management of tracheo-bronchial tree tumors. These interventions providing symptom palliation and improving quality of life. While endoscopic treatment is frequently the best choice, careful consideration about the choice and application of therapeutic implements is essential before treatment.

DISCLOSURE: The following authors have nothing to disclose: Ruxandra Ulmeanu, Ramona Nedelcu, Dan Ioan Ulmeanu, Florin Dumitru Mihaltan

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