Diathermy resection (electrocautery)

In about 30% of patients with inoperable lung cancer the tumour blocks one of the larger airways, which causes problems with breathing. Polyp-like tumours may be removed by diathermy resection (also called electrocautery). 

Diathermy resection may be done through a rigid or a flexible bronchoscope (see 'Investigations'). If the flexible bronchoscope is used, an endotracheal tube (a plastic breathing tube), may be put over the bronchoscope so that the bronchoscope, and a wire loop, can be inserted and removed from the airway repeatedly (to pull out the bits of tumour), without hurting the vocal cords. This is not necessary when the rigid bronchoscope, which is larger, is used. 

The wire loop is used to 'lasso' bits of the tumour, and is used rather like a cheese-wire. Then the bits of tumour are removed. Diathermy cauterises the stalk of the tumour as it is removed, and so keeps bleeding to a minimum. The patient wears a small sticky electrode on the thigh, which carries the return current back to the diathermy machine. The procedure takes about half an hour.

The procedure can cause bleeding, and there is a very small risk of a spark from the diathermy causing the plastic of the tube in the airway to catch fire briefly if the oxygen level is allowed to go too high.

One woman described how she felt before she had a tumour removed from an airway using diathermy resection. She had pain, and great difficulty with her breathing, and was in a panic. Before her operation, which was done using a flexible bronchoscope, she was given a sedative. She remembers waking up in the ward after the procedure feeling much better, breathing easily, without the need for oxygen. She did not recall any side effects of the operation.

Recalls her pain and panic when she could not breathe because her airway was blocked.

The diathermy resection made it much easier for her to breathe.

Several other methods can be used to re-open a blocked airway, including laser therapy (which burns the tumour out of the airway), brachytherapy (localised radiation), and cryosurgery (see 'Cryosurgery and side effects'). An advantage of diathermy resection over some other methods is that diathermy improves breathing immediately, but with some other methods the improvement in breathing may take some time.   

Last reviewed May 2010.

Last update May 2010.