[Intratracheal destruction of tumor lesions: laser or cryotherapy? A preliminary analysis]

Intrabronchial laser has become the reference method for palliative destruction of intrabronchial tumours. Cryotherapy, which destroys tumours by cold-induced lesion at -89.5 degrees C, has recently been introduced. Over a 3-month period, 8 patients with malignant or benign proliferative stenosis of the main bronchi and trachea were treated by laser through a flexible Bronchoscope, under general anaesthesia. During the same period, 8 patients were treated by cryotherapy through a non-rigid probe passed into a bronchoscope, under general anaesthesia; 5 of these patients had malignant intrabronchial lesions and 3 had benign or low-malignancy lesions (hamartochondroma, cylindroma, benign carcinoid). Destruction by laser was relatively or absolutely contra-indicated in these 8 patients on account of total bronchial stenosis, prolonged infiltrating stenosis or previous failure of laser. Satisfactory bronchial recanalization was obtained by laser in 3 out of 8 patients, but this technique partially failed in 5 patients with prolonged or partially infiltrating stenosis; 2 of these 5 patients were successfully treated by cryotherapy. Among the 8 patients treated by cryotherapy, 6 were significantly improved, with total bronchial recanalization and destruction of the tumoral nodules. In 1 case tumoral destruction was too incomplete for re-ventilation, and in the last patient the multiplicity of lesions made objective assessment of the results impossible. No major side-effect ascribable to cryotherapy was observed. Cryotherapy performed through a non-rigid probe therefore seems to be as safe and effective method of bronchial recanalization. It is relatively inexpensive, mobile and painless, but its effects are delayed by 8 to 10 days.(ABSTRACT TRUNCATED AT 250 WORDS)