Tracheoscopic “management” of malformation tumors

The term hamartoma was first introduced by German pathologist Albrecht in 1904 and originally meant a tumor-like malformation consisting of an abnormal combination and arrangement of normal tissues of the organ in which it is located. Pulmonary malformations can be divided into endobronchial type and parenchymal type; they differ only in the location of occurrence: parenchymal type occurs in small bronchi and presents as an isolated, well-defined, hyperdense nodular shadow in the lung; endobronchial malformations can occur in the main bronchi, lobar bronchi and segmental bronchi. The clinical symptoms of endobronchial malformation tumor are often obvious, mostly showing cough, sputum, chest pain, fever, hemoptysis and other symptoms, and the severity and duration of symptoms are related to the degree of tumor obstruction in the lumen. The clinical manifestations depend on the location of the tumor. If the tumor is located in the lobe or main bronchus, the clinical manifestations are mostly recurrent pulmonary infections; if it is located in the trachea, there may be shortness of breath and wheezing; if the tumor occupies more than 2/3 of the tracheal lumen, there may be severe dyspnea and cyanosis. If the tumor occupies more than 2/3 of the tracheal lumen, there may be severe dyspnea and cyanosis. The root of this kind of tumor has a thin tip connected with the bronchial wall. Malignant tumors are slow growing and have a low recurrence rate, so in principle, surgery should be performed promptly. However, surgical treatment is traumatic and takes a long time to recover, especially for the elderly and those with poor lung function, the risk of surgery is greater, and the quality of life after surgery is also significantly affected, so a clear diagnosis must be made before surgery. Electronic bronchoscopy can observe the intraluminal masses more directly and clearly, and improve the diagnosis rate, and also has a therapeutic effect: for endobronchial or wall type malformation tumor, the tumor can be chipped off with electric trap, freezing and thermal ablation (laser or APC) under the direct view of bronchoscope, and generally after repeated treatment, the effect can be cured, avoiding unnecessary trauma caused by surgical resection, and becoming the first choice for treating endobronchial type malformation tumor. It is the first choice for the treatment of endobronchial malformation tumor.