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Ann Thorac Surg 2009;87:1301-1303. doi:10.1016/j.athoracsur.2008.08.045
© 2009 The Society of Thoracic Surgeons
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Makoto Oda
Tsuyoshi Yachi
Go Watanabe
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Management of Tracheobronchial Ulceration Induced By High-Dose Brachytherapy

Isao Matsumoto, MD*, Makoto Oda, MD, Takehisa Imagawa, MD, Tsuyoshi Yachi, MD, Hideki Fujimori, MD, Go Watanabe, MD

Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan

Accepted for publication August 19, 2008.

* Address correspondence to Dr Matsumoto, Department of General and Cardiothoracic Surgery, Kanazawa University, Takara-machi 13-1, Kanazawa, 920-8641, Japan (Email: mat{at}p2223.nsk.ne.jp).

The most severe complication of high-dose endobronchial brachytherapy is fatal hemoptysis. Intractable tracheobronchial ulceration due to high-dose endobronchial brachytherapy often develops into tracheobronchial necrosis and fatal hemoptysis. Our experience demonstrated that when bleeding from tracheobronchial ulcer, after high-dose endobronchial brachytherapy occurs, blocking the blood supply to the tracheobronchial ulcer alone is ineffective. Prophylactic tracheobronchial wrapping using the omentum should be added before the occurrence of fatal hemoptysis. This is the first report that describes an effective management for preventing fatal hemoptysis.






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