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
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 :
2943
-
Downloaded :
866
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