There are two popular methods for endobronchial electrosurgery, namely, excision of
tumors with a diathermic snare and electrodestruction of tumors with a cautery probe.
But, it is nearly impossible to insert the diathermic snare under the tumor base when it
is broad or when the bronchial lumen is tightly obstructed by the tumor, and
electrodestruction requires longer time to ablate tumor tissue than Nd-YAG laser does.
To supplement these weak points of electrosurgery, we designed a new electric probe
shaped like a knife.
Electrosurgery was performed in 10 patients with malignant airway obstruction by
passing the bronchofiberscope via the incubation tube under local anesthesia, and
clean-up bronchoscopy was done 3 to 5 days after electrosurgery. Of the ten patients,
nine had primary lung cancer and one had endobronchial metastasis of renal cell
carcinoma, and in 3 cases the histologic diagnosis was made after the procedure.
Therapeutic results were excellent in five (50.0%), fair in four (40.0%), and poor in
one (10.0%). In 4 cases, FEV1.0 increased two-or three-fold. Endobronchial
electrosurgery was not accompanied by complications except transient fever in two of 10
patients.
Endobronchial electrosurgery is a valuable tool with potential for the diagnosis and
therapy of endobronchial obstructing airway lesion, and the newly-designed electric knife
may be used not only to cut away polypoid lesion but also to destruct tumor tissue.
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