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Ann Thorac Surg 2002;73:348
© 2002 The Society of Thoracic Surgeons

Correspondence

Postoperative fluorescence bronchoscopic surveillance: a worthwhile procedure in a subset of patients

Keyvan Moghissi, FRCSa, J. Andrew C. Thorpe, FRCSa, Kate Dixon, BA, (Hons)a

a The Yorkshire Laser Centre, Goole & District Hospital, Woodland Ave, Goole, East Yorkshire, DN14 6RX, United Kingdom

e-mail: kmoghissi{at}yorkshirelasercentre.org

To the Editor

We read with interest the article by Weigel and colleagues [1] underlining the usefulness of fluorescence bronchoscopy (FB) in the follow-up surveillance for patients undergoing lung resection for cancer.

Notwithstanding the fact that FB was able to diagnose two recurrences among 51 (6%) of their asymptomatic patients who, otherwise, would have remained undiagnosed, they conclude that "despite efforts to streamline the procedure, fluorescence bronchoscopy will remain, at least in the near future, a research tool." While agreeing that for the time being, for practical and economic reasons, it is not realistic to put all operated cases through the rigor of FB, two subgroups would eminently qualify for this surveillance. First, those whose resected specimens show the bronchial marginal section to be microscopically infiltrated by tumor, and second, in patients suspected of having recurrence. In a small series of 13 patients of the latter category, we found two cases whose tumor recurrence after successful resection (in 1 patient) and radiotherapy (in the other patient) was discovered by FB, whereas white light bronchoscopy showed nothing of note.

In cases such as these two subgroups, it is relevant to bear in mind that bronchoscopic photodynamic therapy (PDT) finds one of its prime indications because the inadequate pulmonary functional state of these patients often puts them into the category of inoperable/unresectable. Our 2 patients received PDT with benefit.

References

  1. Weigel T.L., Kosco P.J., Dacic S., Rusche V.W., Ginsberg R.J., Luketick J.D. Postoperative fluorescence bronchoscopic surveillance in non-small cell lung cancer patients. Ann Thorac Surg 2001;71:967-970.[Abstract/Free Full Text]




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