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J Thorac Cardiovasc Surg 2001;121:0180-0182
© 2001 The American Association for Thoracic Surgery

Brief Communications

Endoscopic surgery with a flexible bronchoscope and argon plasma coagulation for tracheobronchial tumors

Shinichiro Okada, MD, Hideyuki Yamauchi, MD, Shotaro Ishimori, MD, Shoichi Satoh, MD, Hiromitsu Sugawara, MD, Yoshiaki Tanaba, MD, Kamaishi, Iwate, Japan

From the Department of Thoracic Surgery and Medicine, Kamaishi Municipal Hospital, Kamaishi, Japan.

Received for publication March 23, 2000. Accepted for publication June 14, 2000. Address for reprints: Shinichiro Okada, MD, Department of Thoracic Surgery and Medicine, Kamaishi Municipal Hospital, Kamaishi, Iwate 026-0025, Japan.

A variety of techniques have been used in an attempt to manage tracheobronchial tumors, such as bronchoscopic neodymium–yttrium-aluminum-garnet (Nd-YAG) laser,Go 1 cryosurgery,Go 2 brachytherapy,Go 3 and electrosurgery with a fiberoptic bronchoscope and a snare.Go 4 However, to date little information is available about argon plasma coagulation (APC) with a flexible bronchoscope in the treatment of endobronchial tumors.Go 5 In this report, we describe the effectiveness and safety of the procedure.

Procedure
APC with a fiberoptic flexible bronchoscope was performed with general anesthesia administered with a laryngeal mask.Go 6 The equipment included a high-frequency surgical unit (ICC350; Erbe, Tuebingen, Germany), a flexible bronchoscope (BF-1T30/BF-LT30; Olympus, Tokyo, Japan), and a flexible APC probe (APCP 20132-048/APCP 20132-049; Erbe, Tuebingen, Germany). The argon flow rate was set at 2 L/min. The high-frequency unit delivered the high-frequency voltage required for ionization in the APC mode. Patients received hydroxyzine hydrochloride and atropine sulfate before the operation. Anesthesia was induced with propofol (2.5-3.0 mg/kg) and maintained with sevoflurane in 67% to 75% air. When necessary, a muscle relaxant such as vecuronium bromide was used. The flexible bronchoscope was passed through the slit of the cap of the swivel connector (Portex Catheter Mount; SIMS Portex Inc, Kent, United Kingdom), which connected the laryngeal mask and anesthesia machine, and it was introduced into the laryngeal . . . [Full Text of this Article]






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