Direct intratumoral injection of ethanol in the patients with obstruction of major bronchus.

Lee, Bong Chun; Yum, Ho Kee; Choi, Soo Jeon; Kim, Dong Soon

doi:1993.40.5.495

Tuberc Respir Dis > Volume 40(5); 1993 > Article

Original Article

Tuberculosis and Respiratory Diseases 1993;40(5):495-500.
DOI: https://doi.org/10.4046/trd.1993.40.5.495 Published online October 1, 1993.

Direct intratumoral injection of ethanol in the patients with obstruction of major bronchus.

Bong Chun Lee, Ho Kee Yum, Soo Jeon Choi, Dong Soon Kim

Department of Internal Medicine, Inje University Paik Hospital, Seoul, Korea

Abstract

Background
For the relief of the occlusion of major bronchi, laser therapy, radiation therapy or combined therapy is generally used. But the effect of radiation therapy is very slow and not consistent and laser therapy requires expensive equipments and technical expertise with occasional serious side effects. Direct ethanol injection has been widely used for the control of bleeding in gastrointestinal lesion, esophageal varices or renal cell carcinoma with good results. So we tried direct injection of ethanol into the tumor to relieve the obstruction of major bronchus in 11 patients.
Method
All procedures were done under the fiberoptic bronchoscopy with continuous oxygen supplement and aliquoted 0.5- 1.0 ml of absolute ethanol directly into the tumor through the endobronchial aspiration needle. The tumor was endoscopically removed with a biopsy forceps immediately after ethanol injection. The whole procedure was repeated 3-4 days interval until the lurnen opens. Usually after 2-3 trials of ethanol injection. the lurnen opened up.
Results
The imrnediate effect of ethanol injection was whitening of the mucosa and prompt cessation of bleeding. The late effect was necrosis of the tumor. The final results of this procedure were improvement of symptoms and reexpnasion of the lung in all patients. FEV_1.0 and FVC were improved and Pa0₂ was increased from 68.1 ± 9.2 mmHg to 83.9 ± 8.1 mmHg, Sa0₂: from 94 ± 8.5% to 96.6 ± 1.1%, and AaD0₂ was reduced from 26.5 ± 8.5 mmHg to 10.9 ± 9.1 mmHg.
Conclusion
Direct ethanol injection into the tumor tissue is a rapid, cheap and relatively safe method of relieving the complete occlusion of major bronchus.

Key Words: Ethanol injection, Bronchial obstruction, Lung cancer

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