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Vol. 13. Issue 5.
Pages 711-719 (September - October 2007)
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Vol. 13. Issue 5.
Pages 711-719 (September - October 2007)
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Ressecção completa de hamartomas endobrônquicos por técnicas broncoscópicas, electrocirurgia por argon plasma e laser Nd-YAG
Complete resection of endobronchial hamartomas via bronchoscopic techniques, electrosurgery by Argon plasma and laser
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Diva Ferreira1,5,
Corresponding author
divafferreira@sapo.pt

Correpondência / Correspondence to: Diva de Fátima Gonçalves Ferreira Rua Conceição Fernandes 4434-502 Vila Nova de Gaia.
, José Almeida2,5, Bárbara Parente3,5, João Moura e Sá4,5
1 Interna complementar de Pneumologia
2 Assistente Hospitalar de Pneumologia
3 Assistente Graduada de Pneumologia. Responsável da Unidade de Pneumologia Oncológica
4 Assistente Graduado de Pneumologia. Responsável da Unidade de Broncologia
5 Centro Hospitalar de Vila Nova de Gaia
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Resumo

Os hamartomas são lesões benignas, geralmente pulmonares, e frequentemente assintomáticos. Tipicamente, são achados acidentais através de estudos radiológicos do tórax. Cerca de 1,4 a 20% dos hamartomas têm localização endobrônquica e podem tornar-se sintomáticos por obstrução da via aérea. A ressecção cirúrgica tem sido o tratamento standard do hamartoma endobrônquico no entanto, tem-se observado uma experiência crescente no tratamento endoscópico sem registo de complicações. Nos casos seleccionados, a ressecção endoscópica tem eficácia terapêutica comparável à ressecção cirúrgica, poupando uma cirurgia.

Os autores apresentam dois casos de hamartomas alendobrônquicos, ambos diagnosticados e tratados definitivamente por técnicas broncoscópicas. Sintomas persistentes e alterações radiológicas torácicas determinaram o estudo por esta técnica. Foi efectuado tratamento endobrônquico através de electrocirurgia por Argon plasma (APC) e laser Nd:YAG, o que permitiu a resolução completa dos sintomas em ambos os doentes. A reavaliação endoscópica regular excluiu doença residual ou recidivante.

Palavras-chave:
Hamartomas endobrônquicos
broncoscopia
electrocirurgia com Argon plasma
laser Nd:YAG
Abstract

Hamartomas are benign neoplasms often located in lung and frequently asymptomatic. They are typically discovered incidentally with thorax radiographic studies. About 1.4–20% of hamartomas have endobronchial location and can be symptomatic due to airway obstruction.

Traditionally, surgical resection has been considered the standard of care for endobronchial hamartoma. However, there is increasing experience using endoscopic treatment and a paucity of reported complications. Endoscopic ressection has comparable therapeutic efficacy with surgical ressection but spares a major operation.

We report two cases of endobronchial hamartomas, each diagnosed and definitively treated with bronchoscopic techniques. Persistent symptoms and abnormal radiological features were the impetus for initial diagnostic bronchoscopy. Endobronchial treatment was performed using electrosurgery by Argon plasma (APC) and Nd:YAG laser. This approach resulted in complete resolution of both patients’ symptoms. Follow-up bronchoscopic examinations excluded residual or recurrent disease

Key-words:
Endobronchial hamartomas
bronchoscopy
electrosurgery with Argon plasma
Nd:YAG laser
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Copyright © 2007. Sociedade Portuguesa de Pneumologia
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