Cryosurgery for the treatment of benign tracheo-bronchial lesions

Although cryosurgery has been shown to be effective in managing advanced malignant bronchial tumours, there is very little in the literature describing its use with benign lesions. In this study, we retrospectively assessed the effectiveness of cryosurgery in the management of non-malignant endobronchial lesions. Between 1995 and 1999, 20 patients with benign tumours and non-neoplastic lesions of the tracheo-bronchial tree were treated with endobronchial cryosurgery. The procedures were performed under general anaesthesia, using specifically designed cryoprobes. The patients were assessed clinically, radiologically and by respiratory function tests before and after each cryotreatment. Over the 5-year period, each patient received a mean 2.6 (range 1-9) cryo-applications, with no peri-operative deaths. All patients described a subjective improvement in at least one of their symptoms (cough, haemoptysis, stridor, chest pain or dyspnoea) following cryosurgery and 75% of patients improved in all symptoms. Following surgery, both forced expiratory volume in 1 s (2.23+/-0.27 vs. 1.98+/-0.25 l, P<0.05) and forced vital capacity (2.86+/-0.33 vs. 2.62+/-0.30 l, P<0.01) improved significantly. In conclusion, cryosurgery can provide effective symptomatic control in patients with non-malignant endobronchial lesions, the majority of whom are discharged on the day of surgery. It affords an easy to perform, safe procedure, which should be considered for patients with benign endobronchial lesions.