2003 Volume 17 Issue 7 Pages 787-793
We present here a case of primary adenoid cystic carcinoma of the trachea, treated by electrosurgical snaring followed by radical operation. We could confirm the heat effects of electrosurgical snaring on the peritracheal soft tissue at the site where tumor resection was performed. The patient was a 62-year-old female with a compliant of dyspnea on effort. Bronchofiberscopy revealed a 10mm smooth surfaced, intraluminal, polyp-like tumor located in the tracheal wall 5.5cm distal from the vocal cords. For airway management and pathological diagnosis, electrosurgical snaring was performed. Histologically, the tumor was diagnosed as an adenoid cystic carcinoma of the trachea. Since the margin of the specimen was positive for cancer cells, radical surgical resection was performed. The effects of heat on her tracheal wall due to endoscopic snaring were confirmed during the operation as degeneration of tracheal cartilage and fibrosis of peritracheal connective tissue, involving the right recurrent nerve. The fibrosis made surgical approach more difficult to preserve the right recurrent nerve.
Electrosurgical snaring requires further study into output power for snaring, output time and snaring position, to minimize the heat effect on peritracheal soft tissue.
