Current Thoracic Surgery 2020 , Vol 5 , Issue 3
Cryosurgery of endobronchial tuberculosis facilitated by Foley’s catheter usage for both intubation and distal airway safety
Şevki Mustafa Demiröz1,Gülşen Yılmaz1,Göktürk Fındık1
1Department of Thoracic Surgery, University of Health Sciences, Ankara Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey DOI : 10.26663/cts.2020.00030 Viewed : 341 - Downloaded : 98 A 35-year-old female with a reproductive cough, dyspnea, stridor, and intermittent hemoptysis was evaluated by fiberoptic bronchoscopy (FOB). An endobronchial lesion was observed 2 cm distal to the vocal cords, occluding two-thirds of the tracheal lumen. Rigid bronchoscopy and total excision of the lesion with cryosurgery were planned. Under general anesthesia, a 14-mm rigid bronchoscope (RB) was introduced. As a facilitative new technique, the patient was intubated with an 18F Foley catheter, which was introduced close to the RB. The cuff of the catheter was then inflated distally to the lesion. Subsequently, the catheter was connected to a mechanical ventilator to ensure the safety of the airway while preventing hypoxia. Total excision of the mass was performed via cryosurgery. Immediately after, the catheter balloon was deflated, and a fiberoptic bronchoscope was introduced through the RB to explore the distal bronchial system for aspirated tissue fragments and secretions. With this facilitative approach, the distal airway was kept clean of secretions and tissue fragments. The final pathology of the mass was granulomatous inflammation and necrosis, and the patient was referred to a tuberculosis clinic for medical treatment. Keywords : dyspnea, endobronchial tuberculosis, endobrochial treatment, cryosurgery