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Electrocautery and cryotherapy in inoperable malignant lung lesions

Abstract

Background

Malignant lung lesions have symptoms that differ according to the lesion site, rate of growth, and diagnosis time. Many palliative modalities have been tried to mange patients’ complaints and improve their quality of life. Bronchoscopic electrocautery and cryotherapy are two different techniques that are used in this field.

Objective

The aim of the paper was to assess the role of cryotherapy and electrocautery as a palliative treatment for inoperable malignant endobronchial lesions.

Patients and methods

A total of 30 patients with inoperable malignant lung lesions were randomized into two groups, 15 patients in each. Group A was subjected to bronchoscopic cryotherapy and group B was subjected to bronchoscopic electrocautery. Dyspnea, cough, hemoptysis, spirometric indices, chest radiography, fiberoptic bronchoscopy, and airway patency were recorded before, 1 week after, and 3 weeks after the last session of each procedure.

Results

In group A, symptoms and chest radiography showed improvement in 26–40% to a little extent after 1 week, but showed significant improvement after 3 weeks in 67–80%. In group B, symptoms and chest radiography showed improvement after 1 week in 46–73% and then improvement increased to a lesser degree after 3weeks in 67–87%. In group A, after 3 weeks, airway reopening was complete in 53.33%, partial in 20%, and no success in 26.67%, whereas in group B, complete success was in 66.67%, partial success was in 20%, and failure was 13.33% (two cases). In group A, 10 (66.67%) patients required 1–4 sessions whereas in group B, only four (26.67%) patients required second session. Complications were few (hemoptysis, arrhythmia, hypoxemia, and bronchospasm), with a higher rate in group B.

Conclusion

Electrocautery and cryotherapy are two different maneuvers for palliative management of endobronchial lesions but with nearly equal outcome on long term. Cryotherapy is safe but requires prolonged time and more than one session are usually required to get satisfactory response, whereas electrocautery is rapid and effective but with few complications.

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Correspondence to Reham M. Elkolaly PhD.

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Elkolaly, R.M., Korraa, E.ED.A. & Ibrahim, I.SE. Electrocautery and cryotherapy in inoperable malignant lung lesions. Egypt J Bronchol 11, 74–80 (2017). https://doi.org/10.4103/ejb.ejb_23_16

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Key words

  • bronchoscope
  • cryotherapy
  • electrocautery
  • malignancy