Ann Thorac Surg 2005;80:1488
© 2005 The Society of Thoracic Surgeons
New technology
Invited commentary
Robert J. Downey, MD
Thoracic Service, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021
(Email: downeyr{at}mskcc.org).
Lunn and co-authors [1] provide a retrospective review of 23 patients who had debridement of the trachea and main bronchi with a "microdebrider" placed into the airway through either a laryngeal suspension system or a rigid bronchoscope during a recent 2-year period. This is a near-novel application of this technology to endotracheal and endobronchial obstructive disease, and the article will be of interest to the general thoracic community.
As the authors state, the primary advantages of the microdebrider compared with other modalities for clearing the airway are (1) that the rapid removal of debrided tissue is made without removal of the debriding instrument, and (2) that there is a reduction of risk of combustion in the airway. It is not clear from this report how much better the microdebrider is compared with currently available and cheaper technology, such as a reusable biopsy forcep. Furthermore, this article provides only a limited demonstration of safety; there is nothing in the text to suggest that the normal tracheal or broncheal wall could not be removed as easily as scar or neoplastic tissue. I would be particularly concerned about application of this device to the more distal, thinner walled airway in which the pulmonary artery is opposed to the outer wall. Finally, this article should be viewed as a feasibility study in that the durability of treatment is incompletely reported. Adequacy of treatment will require a more detailed report that should include information on the manner and length of follow-up and subsequent treatments.
This having been said, the microdebrider appears to represent a very useful addition to the tools already available to the interventional bronchoscopist, and further investigation is clearly warranted.
 |
References
|
|---|
- Lunn W, Garland R, Ashiku S, Thurer RL, Feller-Kopman D, Ernst A. Microdebrider bronchoscopya new tool for the interventional bronchoscopist. Ann Thorac Surg 2005;80:1485-1488.[Abstract/Free Full Text]
Top
References