The heat is on: impact of endobronchial electrosurgery on the need for Nd-YAG laser photoresection

Advances in bronchoscopic electrosurgery have allowed its application in the outpatient setting in patients who otherwise would have required Nd-YAG laser photoresection (LPR) in the operating room. We intended to evaluate the impact of endobronchial electrosurgery (EBES) on the need for Nd-YAG LPR on patients with symptomatic airway lesions. Prospective observational case series. One hundred eighteen evaluations for LPR were performed. Forty-seven evaluations (40%) were considered to be amendable to EBES and were treated during the initial bronchoscopy. The remaining patients underwent LPR. Outpatient bronchoscopy suite at the Cleveland Clinic Foundation, Cleveland, OH. Of the 47 procedures, 42 (89%) were successful in alleviating the obstruction, thus eliminating the need for LPR. No major complications were encountered. EBES can be performed safely in the outpatient setting and is an effective procedure in treating select endobronchial lesions. EBES eliminated the need for LPR in 36% of such procedures with a potential for significant time and cost savings.