title: [Electrocautery and bronchoscopy as a first step for the management of central airway obstruction and associated hemoptysis].
abstract: BACKGROUND
  Central airway obstruction caused by malignant or benign lesions, associated in some cases with hemoptysis, is a condition with high morbidity and mortality. The use of electrocautery by flexible bronchoscopy is an initial treatment option with immediate improvement of obstruction symptoms. It is as effective as Nd: YAG laser.
  
  
  OBJECTIVE
  To describe the usefulness of electrocautery in the management of central obstruction of the airway and hemoptysis.
  
  
  METHODS
  A retrospective, descriptive study of patients referred for management of central airway obstruction or associated hemoptysis. Diagnoses, symptoms (dyspnea, cough, and hemoptysis) and radiology before and after the procedures were analyzed.
  
  
  RESULTS
  Eighteen patients aged 59 ± 12 years (66% males) were evaluated, registering 25 endoscopic procedures. Three conditions were found: partial or complete airway obstruction, hemoptysis and post lung transplant bronchial stenosis. Seventy two percent presented with dyspnea, 61% with cough and 33% with hemoptysis. Sixty six percent of patients had airway obstruction caused by malignant metastatic lesions. After electrocautery, 17 patients (94.4%) improved their symptoms and achieved complete airway clearing. Three patients had significant bronchial stenosis after lung transplant achieving subsequent clearing after electrocautery.
  
  
  CONCLUSIONS
  Electrocautery during flexible bronchoscopy is an effective and safe procedure for the management of central airway obstruction and associated hemoptysis.
authors.affiliation: Departamento de Enfermedades respiratorias y broncoscopia intervencionista, Clínica Santa María, Santiago, Chile, ajalilie@clinicasantamaria.cl.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Jalilie
authors.affiliation: Departamento de Enfermedades respiratorias y broncoscopia intervencionista, Clínica Santa María, Santiago, Chile, ajalilie@clinicasantamaria.cl.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Carvajal
authors.affiliation: Departamento de Cirugía de tórax, Clínica Santa María, Santiago, Chile.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Aparicio
authors.affiliation: Departamento de Anatomía patológica, Clínica Santa María, Santiago, Chile.
authors.forename: Manuel
authors.initials: M
authors.lastname: Meneses
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000209:etiology / Q000601:surgery*; D001980:Bronchi / Q000503:physiopathology / Q000601:surgery; D001999:Bronchoscopy / Q000379:methods*; D003371:Cough; D019468:Disease Management; D004417:Dyspnea; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D006469:Hemoptysis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D053844:Lasers, Solid-State; D008175:Lung Neoplasms / Q000150:complications; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult