Endoscopic resection of an endobronchial hamartoma
Epublication WebSurg.com, Oct 2011;11(10). URL: http://websurg.com/doi/vd01en3415
Invasion of the tracheo-bronchial tree by a malignant pulmonary lesion is the most frequent cause of bronchial obstruction in the adult. However, benign lesions, although rare, may also occur. Hamartoma is amongst the most frequent benign endobronchial tumors. In many cases, these tumors are amenable to endoscopic treatment (either resection or laser ablation), thus sparing the patient the potential morbidity of a thoracotomy and bronchial or parenchymal resection. We present a case of bronchoscopic resection of a hamartoma obstructing the left lower lobe bronchus in a 58-year-old patient who had presented with cough and post-obstructive pneumonia. Key aspects of the procedure include: - Optimal pre-operative evaluation with flexible bronchoscopy and computed tomography of the chest. - Close collaboration between the surgical and anesthesia teams who are sharing responsibility for the airway. - Careful use of energy sources within the airway. - Adequate precautions in case of an unexpected major endobronchial bleed. The prognosis of completely resected benign tumors is excellent. Acknowledgment: we would like to thank Nathalie Leroux RN and Mélodie Leclerc RN for their continued support.