title: A new endoscopic hand drill for management of tracheal stenosis.
abstract: Tracheal resection and primary anastomosis is the treatment of choice for the management of benign tracheal stenoses. Rigid endoscopy with laser-assisted mechanical dilatation is an alternative to surgery and helps to improve symptoms and quality of life in patients unfit for surgery. Here, we describe the treatment of a simple web-like stenosis, using a new endoscopic hand drill that was assembled by sharpening the blunt tip of a standard endoscopic cotton applicator. The bronchoscopy was positioned proximally to the stenotic lesion and radial holes were made at 12, 3 and 9 o'clock. The tip of instrument touched the target area of the stenotic scar. The proximal end was handily rotated and the force, applied on the instrument's tip, and the hole was drilled. Next, endoscopic scissors was placed in the drill holes and the stenotic scar was cut. Mechanical dilatation with rigid bronchoscopes of increasing diameters completed the procedure. This procedure was successfully applied in 5 patients with simple benign tracheal stenosis and unfit for surgery. No intraoperative and/or postoperative complications occurred. No recurrence of stenosis was detected after a mean follow-up of 26 ± 2 months.
authors.affiliation: Thoracic Endoscopic Unit, San Camillo Forlanini Hospital, Rome, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Batzella
authors.affiliation: Thoracic Endoscopic Unit, San Camillo Forlanini Hospital, Rome, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Lucantoni
authors.affiliation: Thoracic Surgery Unit, Second University of Naples, Naples, Italy alfonso.fiorelli@unina2.it.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Fiorelli
authors.affiliation: Thoracic Endoscopic Unit, San Camillo Forlanini Hospital, Rome, Italy.
authors.forename: Raffaele Dello
authors.initials: RD
authors.lastname: Iacono
authors.affiliation: Thoracic Endoscopic Unit, San Camillo Forlanini Hospital, Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Battistoni
authors.affiliation: Pneumology and Endoscopic Unit, Monaldi Hospital, Naples, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Caterino
authors.affiliation: Thoracic Surgery Unit, Second University of Naples, Naples, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Santini
authors.affiliation: Thoracic Endoscopic Unit, San Camillo Forlanini Hospital, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Galluccio
mesh_terms: D000328:Adult; D000368:Aged; D001999:Bronchoscopy; D015331:Cohort Studies; D004724:Endoscopy / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D014135:Tracheal Stenosis / Q000175:diagnosis / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Endoscopic management; Rigid bronchoscopy; Tracheal stenosis