[The place of interventional endoscopy in the treatment of lung cancer]

Interventional endoscopy, by eliminating an obstacle compromising the survival of a patient, has its place in the treatment of bronchial cancer whatever its stage of evolution. Forty percent of patients have not been treated yet, 30 still have therapeutic possibilities at the time of their relapse and for 30% all the possible treatments have been administered and interventional endoscopy remains their only chance of survival. A strict operational protocol ensures safety: operating theatre, general anaesthesia, rigid bronchoscopy, jet-ventilation, post-surgery ICU, and systematic post-surgery fibroscopy. Eighty percent of the patients retrieve normal ventilation. 12% are not sufficiently improved and 3% die either from uncontrollable haemorrhage or from the impossibility of repermeation. The nature of the tumour (primary bronchial cancer, metastasis at distance, invasion from a surrounding cancer) does not enter into the decision to intervene. The benefits of the latter are assessed by the pneumologist or oncologist who is in charge of the patient, but the final decision to intervene naturally remains with the endoscopist.