Summary
Progressive respiratory failure due to massive endobronchial involvement causes death
in some patients with bronchogenic carcinoma. The absence of satisfactory therapeutic
modalities directed specifically at masses of endobronchial tumor has limited our
ability to effectively palliate these patients. Electrocautery is a technique which
has the potential for removing large quantities of endobronchial tumor safely, painlessly,
and without measurable blood loss. It is especially well suited to the patient requiring
local palliation with immediate relief of airway obstruction and without a prolonged
hospital stay. The report reviews: a) its use in an individual with tracheal obstruction;
b) the effect of electrocautery current changes and probe type on canine trachea;
and, c) the technical problems which must be considered in using endobronchial electrocautery.
In the individual with tracheal obstruction, large amounts of tumor were cleared with
excellent hemostasis. The canine trachea demonstrates that the amount and duration
of current used are extremely important. Equipment available for gastrointestinal
electrocautery can produce significant tracheal damage and must be used with great
caution. Finally, fiberoptic bronchoscopes are not designed for electrocautery work,
and care must be employed when performing such procedures through these instruments.
Key words:
Electrocautery - Bronchogenic carcinoma - Respiratory failure - Blood loss
