Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Bronchoscopes”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 577 records · Page 32Linked to original sources
PubMed2006

Evolving role of interventional pulmonology in the interdisciplinary approach to the staging and management of lung cancer: bronchoscopic mediastinal staging of lung cancer.

Mediastinal lymph node involvement is present in 26%-38% of patients with non-small-cell lung cancer at the time of diagnosis, and it is often the most significant factor in determining surgical resectability. Complete and accurate mediastinal staging of lung cancer is essential for determining prognosis and for guiding optimal treatment strategies. Computed tomography and positron emission tomography are the most widely used noninvasive means for mediastinal staging in lung cancer. However, based on their reported specificities, computed tomography and positron emission tomography findings should be verified by cytohistologic sampling. In recent decades, the technique of transbronchial needle aspiration (TBNA) has been developed, permitting the bronchoscopist to obtain cytohistologic material from the hilar and mediastinal lymph nodes adjacent to the tracheobronchial wall. The technique of TBNA has a great specificity, is safe and cost-effective compared with surgical methods, and can be performed during the initial diagnostic bronchoscopy. Transbronchial needle aspiration sensitivity is 76%-78% but is highly influenced by several factors. Endobronchial ultrasound has been proposed as a means for improving TBNA sensitivity. Recently, a new type of bronchoscope with a built-in convex ultrasound probe directly attached to the tip has been developed to guide TBNA under real-time imaging. Reports on this innovative technique reveal a sensitivity of 94%-95.7%, which is superior to the reported sensitivity of surgical methods. However, ultrasound-guided TBNA and traditional TBNA should be considered complementary techniques, because their integration is likely to become the optimal staging strategy for patients with lung cancer.

Biopsy, Needle↗
PubMed1996

Diagnostic yield of bronchoalveolar lavage and bronchoscopic lung biopsy for detection of Pneumocystis carinii.

OBJECTIVE: To assess the need to perform a bronchoscopic lung biopsy (BLB) in addition to bronchoalveolar lavage (BAL) to obtain a definitive diagnosis of Pneumocystis carinii pneumonia. DESIGN: We retrospectively reviewed the results of concurrently collected paired BAL and BLB specimens to determine the diagnostic yield of both methods for the detection of P. carinii organisms. MATERIAL AND METHODS: During a 3-year period, the BAL fluid specimens stained with a commercially available direct immunofluorescence monoclonal antibody (DFA) reagent and the BLB specimens stained with Grocott methenamine-silver nitrate (GMS) were assessed for the presence of P. carinii. BAL fluid was routinely collected from multiple sites and combined into a single specimen for testing. RESULTS: During the 3-year period of study, 119 patients were identified who had paired BAL fluid and BLB specimens tested for the presence of P. carinii. Of the 119 patients, 16 had either BAL fluid that could not be interpreted or BLB tissue that was inadequate. Of the other 103 patients, 21 had P. carinii pneumonia. The sensitivity of the DFA method on BAL fluid and of the GMS method on BLB was 95% and 43%, respectively. CONCLUSION: For detection of P. carinii, the diagnostic yield is significantly higher for DFA-stained BAL specimens than for GMS-stained BLB specimens.

Biopsy↗
PubMed2000

Increasing use of bronchoscopic needle aspiration to diagnose small cell lung cancer.

OBJECTIVE: To review pathology reports to determine whether a temporal change in diagnostic procedures that included bronchoscopic needle aspiration (BNA) in evaluation of small cell lung cancer (SCLC) had occurred. METHODS: A retrospective review of the computerized pathology database of the Wake Forest University Baptist Medical Center from 1990 to 1998 was performed. All pathology reports of patients newly diagnosed with SCLC were reviewed and abstracted. RESULTS: The number of patients newly diagnosed with SCLC during the 9-year study period totaled 277. Of these, 173 underwent bronchoscopy. From January 1990 to December 1991, 32% (8/25) of bronchoscopies done in patients with SCLC included BNA compared with 81% (120/148) (P < .001) from January 1992 to December 1998. In addition to the increased use of BNA in patients with SCLC undergoing bronchoscopy, the overall diagnostic yield for BNA in SCLC significantly increased over the 9-year study period from 50% (4/8) in 1990 and 1991 to 88% (106/120) thereafter (P = .001). Overall sensitivity of BNA during bronchoscopy was 86% for SCLC with only a small increase in sensitivity with use of all procedures (including BNA) to 91%. The use of forceps biopsy and bronchial brushings decreased over this period. CONCLUSION: With progressive experience with BNA, the frequency of its performance and its diagnostic yield in patients with SCLC increased markedly. The SCLC yield may be a worthwhile marker of BNA program development.

Biopsy, Needle↗
PubMed1985

Cryptogenic hemoptysis. Clinical features, bronchoscopic findings, and natural history in 67 patients.

We reviewed the clinical outcome of 67 patients with hemoptysis and a normal or nonlocalizing chest roentgenogram and nondiagnostic fiberoptic bronchoscopic examination. During a 38 +/- 22 (SD) month period after bronchoscopy, 57 (85%) patients remained well without evidence of active tuberculosis or overlooked bronchogenic carcinoma, and 9 patients died of nonpulmonary conditions. One patient developed bronchogenic carcinoma 20 months after bronchoscopy and resolution of symptoms. Hemoptysis had resolved completely before hospital discharge in 38 (57%) patients, within 6 months in 60 (90%), and recurred in only 3. Five patients (7.5%) had intermittent episodes of bleeding for more than 1 year. Fiberoptic bronchoscopy effectively excludes specific underlying causes of hemoptysis in the setting of a normal chest roentgenogram. The prognosis for patients with cryptogenic hemoptysis is generally good, usually with resolution of bleeding within 6 months of evaluation.

Adult↗
PubMed1999

Endobronchial metastasis of glioblastoma multiforme diagnosed by fiberoptic bronchoscopic biopsy.

We report a case of extraneural metastasis of an intracranial glioblastoma multiforme (GBM) to the left upper lung, in which fiberoptic bronchoscopy played a key role in the diagnosis. The patient, a 20-year-old woman, presented with dry cough and hoarseness 2 years after total excision of the brain tumor and postoperative radiotherapy. Tissue samples obtained during fiberoptic bronchoscopic biopsy had the same morphologic appearance as the primary intracranial tumor, which was consistent with GBM. In cases of pulmonary metastasis of GBM, antemortem diagnosis is rare. Our experience from this case suggests that fiberoptic bronchoscopy may be a valuable diagnostic tool for metastatic GBM.

Adult↗
PubMed1999

[Value of CT-guided biopsy compared to fluoroscopy-guided transthoracic biopsy and bronchoscopic sampling in the diagnosis of pulmonary nodules].

CT-guided histological sampling is nowadays used routinely in the differential diagnosis of focal lung diseases with no characteristic morphology. The aim of this study was to determine the value of the method. CT-guided core biopsy was performed in 25 patients with pulmonary nodules. 16 patients underwent bronchoscopy where cytological sampling was also carried out, while 5 patients underwent fluoroscopically guided biopsy. The histological diagnosis resulting from CT-guided biopsy specimens was compared with the findings from the other diagnostic procedures (bronchoscopy or fluoroscopically guided biopsy), with the results of surgery and/or chemotherapy and with the follow-up data. The result of CT-guided biopsy was true in 20/25 and falls in 5/25 cases. Of the 16/25 patients undergoing bronchoscopy, 13/16 gave negative results. In 11/16 cases, the result of the CT-guided biopsy was positive. The fluoroscopically guided biopsy was negative in 4/5 cases, and in 3/5 of these cases the diagnostic CT-guided biopsies proved positive. Our results demonstrate the better diagnostic value of CT-guided core biopsy relative to fluoroscopically guided biopsy or bronchoscopic sampling in those cases where the size and localization of the nodule make it inaccessible with the latter two methods.

Adult↗
PubMed1999

Fiberoptic bronchoscopic placement of self-expandable metallic airway stents for the treatment of tracheobronchial obstruction and fistulas.

Tracheobronchial stent use has been reported in the medical literature for more than 40 years. Silicone stents are the most widely used stents in therapy for varying tracheobronchial lesions at most centers. However, newer designs and modifications of stents are now available with delivery systems that have been designed to facilitate using fiberoptic bronchoscopy. We describe our initial experience placing 13 self-expandable metallic Wallstent stents, including the covered design, in a total of seven patients via a fiberoptic bronchoscope. All patients had benign or malignant obstructing lesions and one patient had an associated malignant tracheoesophageal fistula. The procedure was technically easy and was well tolerated. Following stenting there was a visible increase in airway diameter and a marked improvement in symptoms for all patients. Median survival after stent placement is currently 10 months.

Adult↗
PubMed1999

Bronchoscopic techniques for the diagnosis of pulmonary complications of HIV infection.

Bronchoscopy has played the central role in defining the spectrum of pulmonary disorders that occur in patients with HIV infection. Transbronchial biopsy (TBB) and bronchoalveolar lavage (BAL) both have high yields in the diagnosis of Pneumocystis carinii pneumonia (PCP) and other infections. Paradoxically, despite our knowledge and experience using bronchoscopy, controversy still exists regarding whether to attempt to make a bronchoscopic diagnosis in most patients with suspected PCP who have negative sputum studies or whether to administer initial empiric therapy and reserve invasive diagnostic techniques for patients who have a response. I prefer establishing a diagnosis as soon as possible because bronchoscopy is safe and because the patient may not have PCP and may become too ill to have bronchoscopy after a few days of ineffective therapy. A second controversy relates to the necessity of including routine TBB in addition to BAL during bronchoscopy. Although biopsies increase the risk of pneumothorax and hemorrhage, they add to the diagnostic yield in PCP and other infections. They are also necessary to provide tissue specimens for diagnosing noninfectious pulmonary disorders such as Kaposi's sarcoma and lymphocytic and nonspecific pneumonitis.

AIDS-Related Opportunistic Infections↗
PubMed2001

Pneumopericardium after bronchoscopic carbon dioxide laser surgery--a case report.

A female baby sustained pneumopericardium after bronchoscopic CO2 laser surgery for tracheal stenosis. Perioperative pneumopericardium though rare is a life-threatening condition in babies. The symptoms are usually not specific such as hypotension, bradycardia, muffled heart sound, cardiovascular collapse, etc. The causes and clinical findings of pneumopericardium were reviewed, as are the radiographic features so as to differentiate the condition from pneumomediastinum. Early recognition of pneumopericardium is important, because emergent pericardiocentesis may be required if there is clinical evidence of cardiac tamponade.

Bronchoscopy↗
PubMed2001

[Fluoroscopy-assisted thoracoscopic surgery after computed tomography-guided bronchoscopic barium marking: a minimally invasive treatment for small peripheral early adenocarcinoma of the lung].

We developed a marking technique and subsequent thoracoscopic wedge resection as a diagnostic procedure for small peripheral lung nodule and a treatment for small peripheral early lung cancer. Fluoroscopy-assisted thoracoscopic surgery after computed tomography-guided bronchoscopic barium marking. Through CT-guided bronchoscopy, barium marking is done at just central to the target lesion. Thoracoscopic surgery is performed some days later. The barium marking was grasped in the forceps and resected by endostaplers under both intraoperative fluoroscopic and thoracoscopic guidance. All the lesions could be resected with enough surgical margin. This minimally invasive surgery is indicated for small peripheral in situ adenocarcinoma of the lung.

Adenocarcinoma↗
PubMed2001

Evaluation of learning effectiveness in endotracheal intubation by the use of a laryngoscope in combination with a flexible fiberoptic bronchoscope.

BACKGROUND: Accidental esophageal intubation may cause lethal complications when undetected. We developed a laryngoscope, which utilizes a laryngoscope blade incorporating with a flexible fiberoptic bronchoscope for teaching new learners. We compared two teaching methods, i.e. the traditional method and the new method we contemplated, for teaching new interns. METHODS: We selected new interns as our study group. Everyone had six turns, four of which for the traditional method (T) and two of which for the new method (N), to perform the procedure under the guidance of a teaching supervisor. The interns were assigned randomly to one of three groups. Group 1 used the series of TTTTNN; group 2, TTNNTT; and group 3, NNTTTT. We used success or failure of intubation as the result of our evaluation. Statistical analyses were performed by chi-square test. RESULTS: 84 interns performed 504 endotracheal intubation trials during a period of 4 years. There was a 91.7% success rate with the new method and a 78.9% success rate with the traditional technique (P < 0.05). The group to which the new method was initially taught achieved the highest success rate of intubation and the greatest feeling of satisfaction according to a self-evaluation record. Of the failed intubations, 82.4% were due to performing the procedure in more than one minute, 15.3% due to esophageal intubation and the remaining 2.3% due to contact bleeding of teeth or oral trauma. CONCLUSIONS: By using the new teaching method, the supervisor could easily teach and assess the success of the new learners. Besides, esophageal intubation could be reduced to a minimum with subsequent increase of success rate.

Anesthesiology↗
PubMed2000

[Transbronchial needle aspiration in routine bronchoscope practice].

OBJECTIVE: To evaluate the yield of transbronchial needle aspiration (TBNA) in a clinical routine bronscopy practice after training under the guide by CT scanning. METHODS: Using Wang TBNA System and CT scanning methods to define the site in airway for puncturing the enlarged mediastinal lymphnode. The positive rate of TBNA was 64%, almost equal to the positive rate (61%) of the method by operating directly under CT scanning. TBNA was performed on 100 consecutive patients with 152 enlarged mediastinal nodes undergoing diagnostic fiberoptic bronchoscopy. RESULT: The positive rate (64%) was equal to the positive rate (61%) under the CT guide. CONCLUSIONS: CT guiding TBNA is very useful for training doctors to learn the TBNA technique, and TBNA can be done very well and play an important role in routine bronchoscope practice.

Biopsy, Needle↗
PubMed2002

[Results of bronchoplasty by fiberoptic bronchoscopic balloon dilatation in the management of proximal benign tracheobronchial stenosis].

OBJECTIVE: To assess the effect and safety of balloon dilatation through fiberoptic bronchoscopy in the management of benign tracheobronchial stenosis. METHODS: Thirty-seven patients with proximal benign tracheobronchial stenosis were treated by balloon dilatation through flexible fiberoptic bronchoscopy. A fiberoptic bronchoscope was inserted, a balloon catheter was sent to the stenotic segment from the working channel and positioned in the stenotic bronchus. Under direct visualization, the balloon was inflated for 1 min to 3 min. Repeat inflation-deflation cycles were done if airway narrowing remained after the initial operation. Before the procedure and immediately after the last operation, airway diameters, dyspnea index and complications were evaluated in all of the patients and FEV(1) was tested in 26 of the 37 patients. RESULTS: One to 6 operations (2.4 +/- 1.1, approximately x +/- s) were required to achieve satisfactory dilatation. After high-pressure balloon dilatation, the average airway diameter increased from (2.6 +/- 1.2) mm to (6.9 +/- 1.8) mm (P < 0.01). Dyspnea index decreased from 2.0 +/- 0.8 to 0.7 +/- 0.6 (P < 0.01). FEV(1) was increased from (1.3 +/- 0.6) L to (1.8 +/- 1.0) L (P < 0.01). No severe complications were found in these patients CONCLUSION: Bronchoplasty by high-pressure balloon dilatation through flexible fiberoptic bronchoscopy is a simple but effective and safe method to treat proximal benign tracheobronchial stenosis.

Adolescent↗
PubMed1992

[Characteristics and problems of flow cytometric nuclear DNA content analysis in lung cancer using bronchoscopically-obtained specimens].

Flow cytometric nuclear DNA content analysis was performed on 106 bronchoscopically-obtained specimens from 67 patients with primary lung cancer. Brushing, curettage and biopsy samples in which tumor cells were identified by microscopic examination were considered suitable for analysis. The incidence of DNA aneuploidy in small cell carcinoma (77.8%) was higher than that in any other histological type of lung cancer. Intratumoral heterogeneity was found to affect the detectability of DNA aneuploidy, suggesting that care must be taken to obtain adequate samples of tumor cells and to consider intratumoral heterogeneity. These results indicate that this method can be used for nuclear DNA content analysis not only in cases of resectable lung cancer but also for unresectable lung cancers and may provide useful biological information in the clinical management of all types of lung cancer.

Adenocarcinoma↗
PubMed2006

[Bronchoscopic lung volume reduction surgery in emphysema].

Despite of the clinical studies proving the benefits of lung volume reduction surgery and determining the indications and candidates, the surgical intervention has not penetrated into the standard treatment of emphysema. Perioperative mortality is relatively high at patients with end-stage emphysema, therefore a less invasive procedure might be most useful in medical practice. Bronchoscopic lung volume reduction is a technically simple procedure including insertion of a bronchial blocker (plug) or an endobronchial valve, either totally blocking the air flow, or blocking it only during the inspiration. However, there are only few clinical data available concerning of surgical and bronchial interventions. A multinational clinical study is in progress in three Hungarian pulmonological centers implanting endobronchial plugs into the subsegmental bronchi of patients with severe emphysema.

Bronchoscopy↗
PubMed2006

Management of endobronchial cancer using bronchoscopic electrocautery.

From December 2004 until November 2005, 15 cases of endobronchial cancer presenting with 22 episodes of mechanical obstruction of the airway, difficulty in breathing, hemoptysis, severe coughing, obstructive pneumonia and identified recurrent atelectasis of the lungs. The cancer was removed rapidly, effectively and without complication by a technique of fiberoptic bronchoscopic electrocautery.

Adenocarcinoma↗
PubMed2006

[Application of bronchoscopic lung volume reduction using one-way flap device in sheep model of heterogeneous emphysema].

OBJECTIVE: To evaluate the effectiveness of bronchoscopic lung volume reduction (BLVR) using one way flap device in sheep model of heterogeneous emphysema. METHODS: Six 6-month sheep (weight: 20-30 kg) were treated with localized papain instillations to generate heterogeneous emphysema, subsequently underwent BLVR using one way-flap device at subsegment. Lung functional residual capacity (FRC) was analyzed before and 8 weeks after operation. Animals were euthanized at the 8-week time point. Lungs were removed en bloc and inflated with a super syringe to look for areas of gross collapse. Samples were collected from collapsed and non-collapsed areas, fixed in 10% buffered formalin, made paraffin section and stained with hematoxylin-eosin (HE) to observe morphologic change of bronchi. RESULTS: BLVR was well tolerated without complications, and it reduced lung volumes (change in residual volume 49.5%). There was no evidence of infection, abscess, or granuloma formation, or allergic reaction. Scar tissue, generated by BLVR, replaced hyperinflated lung,improved respiratory function safely and consistently. CONCLUSION: BLVR using one-way flap device is a minimally invasive procedure and the stimulus of the devices to walls of bronchi is slight, moreover, the technique may attain effectiveness of surgery. Therefore maybe it will be a perspective treatment of chronic obstructive pulmonary disease.

Animals↗