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Morphological changes induced by extensive endobronchial electrocautery
C Verkindre1, A Brichet, C A Maurage
1Clinique des Maladies Respiratoires, Hôpital A. Calmette, CHRU de Lille, France.
The European Respiratory Journal
|November 26, 1999
Summary
Electrocautery for therapeutic bronchoscopy can cause significant bronchial wall damage, including fibrosis and cartilage deterioration, leading to secondary stenosis. Operators should exercise caution when treating extensive bronchial wall tumors.
Area of Science:
- Pulmonology
- Interventional Bronchoscopy
- Surgical Pathology
Background:
- Electrocautery is gaining interest in therapeutic bronchoscopy for intraluminal tumor destruction.
- Its effects on bronchial wall morphology are not well understood.
- This knowledge is crucial as electrocautery is proposed for superficial bronchial wall tumors.
Purpose of the Study:
- To investigate the morphologic changes in bronchial wall structures induced by electrocautery.
- To assess early and late effects of electrocautery on the trachea and main bronchi.
Main Methods:
- Soft coagulation electrocautery (40 W and 120 W) was applied to the trachea and left main bronchus in 52 piglets.
- Early (48 h) and late (6 weeks) effects were evaluated via gross examination (bronchoscopy, autopsy) and light microscopy.
Main Results:
- Early effects included mucosal coagulation necrosis and acute inflammation extending deep into the bronchial wall.
- Late effects revealed transmural fibrosis and cartilage plate deterioration, independent of power setting.
- These changes resulted in scar formation, loss of cartilaginous support, and iatrogenic secondary stenoses.
Conclusions:
- Electrocautery can induce significant, potentially harmful, structural changes in the bronchial wall.
- While effective for intraluminal tumors, caution is advised for extensive bronchial wall infiltrations due to risks of stenosis.