- 期刊
Endobronchial Hamartoma Removed by Flexible Bronchoscopy via Electrocautery-A Case Report
支氣管內過誤瘤藉由支氣管鏡電燒灼術切除
摘要
氣管的原發性腫瘤通常為惡性居多（90%），大約只有10% 左右是良性的。在這些良性腫瘤中，纖維瘤，神經鞘瘤（許旺氏細胞瘤），平滑肌瘤，以及過誤瘤都有可能被發現。大約1.4-20%的過誤瘤會位於氣管內，且因為氣道的阻塞而造成症狀。傳統的觀念中，外科手術切除被認為是支氣管內過誤瘤的標準治療。然而，內視鏡切除的治療效果與外科手術治療是相當的，還可以減少動大手術之需要。我們在此報告一位56歲女性病患因支氣管內過誤瘤而導致右中肺及右下肺阻塞性肺炎的病例，藉由支氣管鏡的介入性處置獲得到明確的診斷及充分的治療。支氣管內治療是藉由可曲式支氣管鏡加上電燒灼術的方式進行。如此的處置方式可以完全緩解病患的症狀。而在此氣管內治療後，我們追蹤此病患長達一年，並未發現有殘餘或復發性病灶的發生。微侵入性支氣管鏡切除術對於支氣管內過誤瘤而言，是一項安全、有效，且產生併發症機率低的治療方式。
並列摘要
Primary tumors of the trachea are usually malignant (90%). Only 10% of them are benign, and include fibroma, schwannoma, leiomyoma and hamartoma. About 1.4-20% of hamartomas has an endobronchial location and can be symptomatic due to airway obstruction. Surgical resection has been considered traditionally as the standard of care for endobronchial hamartoma. However, endoscopic resection has a therapeutic efficacy comparable to surgical resection, but spares a major operation. Herein, we report a 56-yearold female with an endobronchial chondroid hamartoma complicated with obstructive pneumonia in the right middle lobe and the right lower lobe that was diagnosed and definitively treated with bronchoscopic techniques. Endobronchial treatment was performed using a flexible bronchoscope with electrosurgery. This approach resulted in complete resolution of the patient's symptoms. Follow-up bronchoscopic examinations 1 year after the bronchoplasty procedure excluded residual or recurrent disease. Minimally invasive bronchoscopic resection for endobronchial harmatoma is a safe, effective method with a low complication rate.