PubMed · 13248521
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P DE HAAN. Flexible bronchoscope.. https://pubmed.ncbi.nlm.nih.gov/13248521/
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Surgical lasers are an excellent tool for the treatment of airway lesions. Distal tracheal lesions offer a greater challenge in that they are less accessible to laser treatment relative to upper airway lesions yet retain the propensity to cause complete airway obstruction. The ideal treatment modality for the endoscopic ablation of distal tracheal lesions provides secure airway protection, excellent visualization of the lesion in question, and delivery of a safe and effective method of treatment. We have found that the use of a contact Nd:YAG fiberoptic delivery system through a rigid bronchoscope has performed very well in meeting these criteria.
The mycobactericidal activity of Perasafe (0.26% peracetic acid) was compared with that of Cidex (2% alkaline glutaraldehyde) by an in-use test. Fibreoptic bronchoscopes were artificially contaminated with Mycobacterium tuberculosis or Mycobacterium avium-intracellulare in sputum and, after manual pre-cleaning with a neutral soap, 10 and 20 min disinfection periods were tested. Perasafe was as effective as Cidex, thus requiring a 10 min disinfection period against M. tuberculosis and 20 min against M. avium-intracellulare. The results demonstrate that Perasafe is an effective disinfectant for use in reprocessing fibreoptic bronchoscopes.
Many patients with lung cancer develop airway obstruction and hemoptysis. Endoscopic palliation can relieve symptoms and improve the quality of life for many patients. Patient factors, lesion characteristics and location, and regional expertise are important to consider when planning therapy. Cost, convenience, time to relief of symptoms, duration of palliation, and the need for serial procedures should also be considered. Further advances in technology will likely allow better palliation in the future. A wide armamentarium of modalities and careful communication with the patient's other providers are essential for optimal patient outcome.