Bronchoscopic Laser Interstitial Thermal Therapy: An Experimental Study in Normal Porcine Lung Parenchyma

Journal of Bronchology & Interventional Pulmonology
Roberto F CasalGeorge A Eapen

Abstract

Population aging and lung cancer screening strategies may lead to an increase in detection of early-stage lung cancer in medical inoperable patients. Recent advances in peripheral bronchoscopy have made it a suitable platform for ablation of small peripheral tumors. We investigated the tissue-ablative effect of a diode laser bronchoscopically applied by a laser delivery fiber (LDF) with wide aperture on porcine lung parenchyma. Laser was tested ex vivo and in vivo to identify the most effective power settings and LDF. Chest computed tomography (CT) were obtained immediately after ablation and after 3 days of observation. At day 3, necropsy was performed. On the basis of our ex vivo and in vivo experiments, we selected the round-tip LDF to be activated at 25 W for 20 seconds. Ten ablations were performed in 5 pigs. One ablation resulted in a pneumothorax requiring aspiration. All animals remained stable for 72 hours. CT findings at days 1 and 3 showed an area of cavitation surrounded by consolidation and ground glass. Median size of CT findings (long axis) was 26 mm (range, 24 to 38) at day 1, and 34 mm (range, 30 to 44) at day 3. Necropsy showed an area of central char measuring from 0.8×0.7×0.9 cm to 2.4×3.5×1.2 cm, surrounded...Continue Reading

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Citations

Jul 10, 2020·Respirology : Official Journal of the Asian Pacific Society of Respirology·Daniel P Steinfort, Felix J F Herth
Jun 14, 2019·Annals of the American Thoracic Society·Udit ChaddhaSeptimiu Murgu
Oct 22, 2020·ERJ Open Research·Jan SebekPunit Prakash
Feb 17, 2021·American Journal of Therapeutics·Abhinav Agrawal

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