Use of microdebrider bronchoscopy for the treatment of endobronchial leiomyoma

Abstract

Aims: Pulmonary leiomyomas are rare benign tumors that may cause symptoms when they spread endobronchially. Traditionally they were managed surgically or through interventional bronchoscopy with the aid of thermal modalities to assist in debulking of tumor. We report the novel use of microdebrider bronchoscopy to debulk an endobronchial leiomyoma in a symptomatic patient. Method/Results: The microdebrider successfully débrided the endobronchial leiomyoma. Conclusion: This modality can be successfully employed when oxygenation is an issue, preventing use of thermal modalities. In addition, use of microdebrider not only reduced procedure time but also decreased the risk of airway fire and damage to adjacent normal tissue in our patient.Please cite this paper as: Wahla AS, Khan I, Bellinger C, Haponik E and Conforti JF. Use of microdebrider bronchoscopy for the treatment of endobronchial leiomyoma. Clin Respir J 2011; 5: e4-e7.

Malignant central airway obstruction

“…The microdebrider is an efficacious tool in skilled hands (44)(45)(46)(47). In the largest study evaluating this instrument for both malignant and benign central obstruction (48) the operators were able to consistently recanalize the airway lumen resulting in a mean residual airway obstruction of only 10%.…”

Safety and effectiveness of microdebrider bronchoscopy for the management of central airway obstruction

“…After Lunn's initial feasibility study-which included only three patients with malignant CAO-there has not been any further relevant literature on this topic, except for anecdotal case reports. 12,[14][15][16] To the best of our knowledge, this is the largest study on microdebrider bronchoscopy providing evidence on its safety and efficacy for the management of both benign and malignant CAO. In our study, almost 50% of the patients had severe airway obstruction, representing a high-risk population prone to develop suboptimal oxygenation and ventilation intraoperatively.…”

“…The use of microdebrider bronchoscopy for the management of CAO is relatively new and data on effectiveness and safety are limited, particularly for malignant disease. After Lunn's initial feasibility study—which included only three patients with malignant CAO—there has not been any further relevant literature on this topic, except for anecdotal case reports . To the best of our knowledge, this is the largest study on microdebrider bronchoscopy providing evidence on its safety and efficacy for the management of both benign and malignant CAO.…”

Therapeutic Relief of Benign Endobronchial Tumors

“…One case report describes the novel use of a microdebrider after argon plasma coagulation to debulk an obstructing leiomyoma in the right mainstem. 16 …”