Injuries of the trachea and bronchi

Traumatic rupture of the trachea or the bronchi is reported with increasing frequency. Such rupture may follow penetrating wounds, but the common cause is blunt trauma of the throat or thorax.     

Squamous papillomatosis of the trachea and bronchi

A squamous papilloma which occluded the trachea of a young man was managed by resection at tracheotomy. Thereafter it was possible further to examine the bronchi bronchoscopically, and widespread papillomatosis confined to the left bronchi was seen. Following bronchography, which showed left-sided bronchiectasis, left pneumonectomy was undertaken. Case details are presented and the literature which relates to bronchial papillomatosis is reviewed.     

Management of benign and malignant lesions of the trachea and bronchi with the neodymium-yttrium-aluminum-garnet laser

Fifty patients with lesions of the trachea or bronchi have been treated with the neodymium-yttrium-aluminum-garnet laser. Forty-three patients had advanced carcinoma of the lung with pulmonary infection or abscess distal to an obstructing bronchial lesion or else had hemoptysis. Benign lesions were seen in seven patients. A total of 72 laser treatments were administered for obstruction and/or hemoptysis. There was no significant morbidity and only one hospital death occurred, which was unrelated to the laser therapy. Among the 43 patients with malignant disease, obstructive complications and hemoptysis were controlled in 39. All those with benign lesions have been significantly improved. Presently 22 patients with malignant disease remain alive and are symptomatically improved. The longest survival after successful laser treatment has been 73 weeks, and 34 survived longer than eight weeks. This laser is a very effective means of managing patients with benign lesions and offers significant palliation for patients with hemoptysis and advanced obstructing carcinoma of the trachea or main-stem bronchus.     

Endoscopic surgery of trachea and bronchi

More than twenty-year experience of performance of endoscopic laser operation (ELO) on trachea and bronchi in patients with malignant and benign tumors was summarized. Cancer of trachea and bronchi of I-II stages was noted in 3, of III stage--in 384, of IV stage--in 205 patients, adenoma of bronchus--in 13. Technical possibilities of Nd-YAG laser were demonstrated. The immediate and follow-up results of operative intervention, subsequent possibilities of combined treatment of patients using, after ELO conduction, the extended intervention in combination with radiation therapy and chemotherapy.