ABSTRACT
Endobronchial electrocautery is a tool with diagnostic and therapeutic applications in the management of obstructing endobronchial disease. We have performed cautery procedures in 18 patients. Of these 18, five patients had benign diagnoses and 13 had malignancies. All patients with benign lesions had only endobronchial resections and four have done well. Four procedures resulted in the establishment of a diagnosis which had eluded other biopsy techniques. In 11 patients with malignant disease, electrocautery was used for palliation of airway obstruction, and in two patients, the snare was used as a biopsy technique. There have been no complications while utilizing the snare; however, application of electrocautery probes was associated with two complications. Our experience demonstrates the value and safety of using cautery wire snares to diagnose and treat endobronchial lesions.
Subject(s)
Bronchial Diseases/surgery , Electrocoagulation/methods , Bronchial Neoplasms/surgery , Electrocoagulation/instrumentation , HumansABSTRACT
The magnitude of the smoking problem is overwhelming. The annual mortality and expense are staggering. The task of changing this apocalyptic problem seems impossible. The solution, however, is not remote: It begins with each physician and with each individual patient who smokes. A consistent attitude of nonacceptance of the smoking habit with recommendations and support for discontinuation can make a significant impact on the problem. Extension of this attitude into community affairs and regional and national politics will result in increased public awareness and eventually in the majority rejecting this costly habit.
Subject(s)
Smoking , Cardiovascular Diseases/economics , Cardiovascular Diseases/etiology , Economics , Female , History, 19th Century , History, 20th Century , History, Ancient , Humans , Lung Neoplasms/economics , Lung Neoplasms/etiology , Male , Physician's Role , Pregnancy , Respiration , Smoking/history , Smoking Prevention , Tobacco Smoke Pollution , Tobacco Use Disorder/psychology , United StatesABSTRACT
Endobronchial electrocautery was successfully used to treat three patients with major airway obstruction resulting from bronchogenic carcinoma and to establish a diagnosis in a fourth. Electrocautery was applied through fiberoptic bronchoscopes. In two cases, a wire snare was used to remove polypoid lesions and in two others, probes were used to ablate tumor tissue. As a result of high inspired oxygen concentration in one patient, a tracheal fire occurred without injury to the patient. Electrocautery is an available economical tool which has potential value in the diagnosis and therapy of endobronchial obstructing airway lesions.
Subject(s)
Bronchoscopes , Carcinoma, Bronchogenic/surgery , Carcinoma, Squamous Cell/surgery , Electrosurgery/methods , Lung Neoplasms/surgery , Tracheal Neoplasms/surgery , Aged , Electrosurgery/adverse effects , Female , Fiber Optic Technology/instrumentation , Fires , Humans , Intraoperative Complications , Male , Middle AgedABSTRACT
An asymptomatic 18-year-old man presented for treatment of alcohol and substance abuse. He related a history of a recent motor vehicle accident with chest trauma and remote history of colonic interposition for esophageal atresia. Radiographic investigation yielded an interesting set of roentgenograms.
Subject(s)
Embolism, Air/diagnostic imaging , Esophagus , Pneumothorax/diagnostic imaging , Adolescent , Diagnosis, Differential , Esophagus/diagnostic imaging , Humans , Male , RadiographyABSTRACT
Laryngospasm developed in a 33-year-old woman following attempted endotracheal intubation. Following establishment of the airway, the patient developed pulmonary edema which was successfully treated by conventional means. The sequence of events suggests that laryngospasm precipitated the development of the pulmonary edema in this patient.
