ThE Role of Endoscopic Surgery for Completely Obstructive Endobronchial Benign Tumor

Abstract

BackgroundThe improving techniques of therapeutic bronchoscopy have been replacing conventional surgery for resecting endobronchial benign tumor. However, there could be some limitation for performing bronchoscopic intervention for the patients with complete bronchial obstruction. To evaluate the role of endoscopic surgery for completely obstructive endobronchial benign tumor, we retrospectively reviewed the medical records of 7 patients who underwent bronchoscopic resection due to completely obstructive benign tumor.MethodsRigid bronchoscopy was performed under general anesthesia. After the stalk of tumor was identified with using a 1 mm biopsy forceps as a probe, a Nd-YAG laser was used to coagulate the stalk of tumor. The tumor was then removed.ResultsBronchoscopic resection was successful in 6 out of 7 patients. The histological diagnoses were 3 leiomyomas, 3 harmatomas and 1 lipoma. There was no mortality in our study. Pneumomediastinum developed in 1 patient, and this patient was treated with 3 days of oxygen therapy. In 5 out of the 6 successful patients, there was no recurrence for a median of 35 months. In 1 patient, leiomyoma recurred after 17 months, and this was treated by pneumonectomy.ConclusionsEndoscopic surgery could be applied to the patients with completely obstructive endobronchial benign tumor.

Bronchoscopic resection of bronchial angiolipoma: A rare case report

“…In the only previous report of bronchial angiolipoma, the authors performed successful localized resection of the lesion and suggested complete surgical resection was advisable if the patient was able to tolerate the procedure. However, some scholars consider bronchoscopic resection, which was employed in the present case, to be the preferred method, as rare benign tumors characterized by slow growth may carry a low risk of malignant transformation (11,17,18). Endoscopic resection includes laser ablation, electrocauterization, cryorecanalization and electrosurgical snaring (19).…”

Therapeutic Relief of Benign Endobronchial Tumors

“…One cardiac arrest attributed to anesthesia occurred of 220 patients making the mortality rate of bronchoscopically debulking benign tumors 0.5% in this review. 1,8,[13][14][15] Although benign lung tumors are rare, their occurrence endobronchially is even less common. However, the use of interventional techniques to treat or debulk these tumors when they are confined to the endobronchial lumen and accessible by rigid or flexible bronchoscopy (ie, within the trachea, mainstem bronchi, bronchus intermedius, or proximal lower lobe bronchi) can spare the symptomatic patient from surgery.…”

“…The majority of interventionalists in these published studies used rigid bronchoscopy (95%) and Nd:YAG laser therapy (92%) with mechanical debulking. 1,5,[7][8][9][10][11][12][13][14][15] Flexible bronchoscopy is also an option though we recommended that patients be under general anesthesia with endotracheal intubation for airway control if debulking is pursued with this method. The rigid bronchoscope has the advantage of enabling the operator to maneuver larger suctioning during treatment and destruction.…”

Endobronchial hamartoma: a rare disease with more common presentation

“…The majority of lung hamartomas involve the lung parenchyma and only infrequently grow as endobronchial tumours 3–5. These tumours occur more frequently in men3 6–11 and usually in the elderly 4 6 12. Even though the majority of patients will have an abnormality on a chest radiograph, lung hamartomas are usually asymptomatic 4 12–15.…”

“…Even though the majority of patients will have an abnormality on a chest radiograph, lung hamartomas are usually asymptomatic 4 12–15. Obstructive pulmonary symptoms have been reported 12 13. CT scans of the chest and bronchoscopy are useful diagnostic tools 2 3 7 11 16.…”