Tissue effects of bronchoscopic electrocautery: bronchoscopic appearance and histologic changes of bronchial wall after electrocautery.
OBJECTIVE
To study tissue effects of bronchoscopic electrocautery (BE).


METHODS
In six patients with non-small cell lung cancer, a BE procedure was performed immediately before surgery. After patients were placed on ventilation, normal mucosa on different carinae was treated with a cautery probe (2-mm(2) surface area) at a power setting of 30 W with a variable time of application of 1 to 5 s. Bronchoscopic appearance of the treated area was documented photographically, and histologic changes of the bronchial wall were examined.


METHODS
Bronchoscopy unit of a university hospital.


RESULTS
BE resulted bronchoscopically in whitening of the bronchial mucosa with crater-shaped lesions. After longer duration of BE application, deeper craters with more profound charring were seen. Histologic changes of the lesions showed craters containing a variable amount of necrotic tissue. In one case, thin subsegmental carinae were coagulated and measurements could not be performed. In the remaining five cases, microscopic findings revealed 0.2 +/- 0.1-mm necrosis after 1 s; 0.4 +/- 0.2-mm necrosis after 2 s; 0.9 +/- 0.5-mm necrosis after 3 s; and 1.9 +/- 0.8-mm necrosis after 5 s. A variable degree of tissue damage surrounding the necrotic tissue area was found. In one case, cartilage damage appeared after 3 s of coagulation, and extensive damage of the underlying cartilage was seen in four cases after 5 s of application.


CONCLUSIONS
Superficial damage was obtained by short duration of BE (< or = 2 s), and longer duration of coagulation (3 s or 5 s) caused damage to the underlying cartilage. Bronchoscopic appearance after endobronchial electrocautery corresponded with the histologic changes.
van Boxem
T J
TJ
Departments of Pulmonary Medicine, University Hospital Vrije Universiteit Amsterdam, the Netherlands.
Westerga
J
J
Venmans
B J
BJ
Postmus
P E
PE
Sutedja
T G
TG
D000328:Adult; D000368:Aged; D001980:Bronchi / Q000473:pathology / Q000601:surgery*; D001999:Bronchoscopy; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000601:surgery*; D004564:Electrocoagulation; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D011013:Pneumonectomy / Q000379:methods*; D011183:Postoperative Complications / Q000473:pathology*; D020545:Respiratory Mucosa / Q000473:pathology