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At least 631 records · Page 35Linked to original sources
PubMed1980

Bronchoscopic CO2 laser surgery.

The problem of removing or palliating obstructing lesions of the trachea nd bronchi has been solved by using the CO2 laser in conjunction with an endoscopic adaptor. We have used this laser successfully in 18 patients who had this particular problem. The advantages of laser surgery in this area are 1) reduced bleeding, 2) minimal exposure of the surgical field, 3) decreased swelling, 4) decreased postoperative hospital stay and less discomfort, and 5) no tumor spread or seeding. Patient acceptability of this modality is excellent, and general general, as well as local, anesthesia can be used. The results of laser ablation in the tracheobronchial tree have been quite satisfactory and can be repeated as often as necessary.

Adult↗
PubMed2000

[Remifentanil-propofol for bronchoscopic fiber optic intubation under capnographic control].

UNLABELLED: We report a case of a 41-years-old woman presenting for revision of a secondary reconstructive procedure using the modified Tagliacozzi upper arm flap after subtotal maxillectomy. Because of the pedicle flap the upper arm was fixed in a pre-facial position and so fiberoptic intubation was required. After routine pre-anesthetic preparations and topical anesthesia of the nares and nasopharynx a CO2 measuring catheter as well as a O2 catheter to administer 100% oxygen was inserted deeply into the left naris. At that time, a continuous infusion of 0.05 microgram/kg/min remifentanil and 2 mg/kg/h propofol was started. After 4 min, fiberoptic intubation was performed through the right nare without any technical difficulties in conscious sedation of the patient. During the entire fiberoptic intubation SaO2 was constant at 100% and capnogram tracings with etCO2 values ranging from 31 to 33 mmHg were displayed on the monitor. At the end of this second surgical procedure with fixed pre-facial upper arm position the patient was uneventfully extubated fully awake. For the time period of fiberoptic intubation the patient had complete amnesia. CONCLUSION: With the use of nasal capnography and capnometry in addition to simultaneous O2 administration during fiberoptic intubation under extreme conditions excellent analgosedation with propofol and remifentanil could be provided without compromising our patients' safety. The presented CO2 measuring and O2 administering device represents a simple and cheap expansion of standard anesthetic monitoring during fiberoptic intubation.

Adult↗
PubMed2004

Are difficulties during transbronchial lung biopsy/brushing through a fiberoptic bronchoscope based on the bronchial anatomy?

Some of the difficulties encountered during transbronchial lung biopsy through a flexible bronchofiberscope are due to anatomical reasons, namely the branching angles of some subsegmental bronchi from their mother bronchi are large, and differences in branching angles during respiration may also be large. This makes insertion of forceps difficult. We have sometimes experienced difficulties reaching the target lesion during a transbronchial approach. Which subsegmental bronchi make transbronchial lung biopsy/brushing difficult, and are such difficulties due to anatomical reasons? To answer these questions, we firstly surveyed 10 bronchologists regarding which five subsegmental bronchi they considered to be the most difficult for transbronchial biopsy/brushing. We then measured the branching angles of subsegmental bronchi in 106 cadaver lungs. Finally, in six volunteers, we also measured differences in branching angles of the subsegmental bronchi between the point of forced inspiration and the point of forced expiration on CT images. According to the survey, left B(1+2)c was considered to be the most difficult for insertion by nine doctors, followed by bilateral B6a by seven, right B1a by five, left B3a by five and left B(1+2)a by four. The results of our dissections showed that a branching angle of over 60 masculine was present in more than 10% of specimens in B3a, B6a and B6c in the right lung and in B(1+2)c, B3a, B6a and B6c in the left lung. In addition, three-dimensional reconstructed images revealed that the angles of some subsegmental bronchi changed during respiration. Inter-individual variations were present in most subsegmental bronchi. The direction of movement of each subsegmental bronchus during respiration varied. In addition, maximum degrees of difference in angles between volunteers were sometimes as much as 80 degrees . In conclusion, branching angles of subsegmental bronchi from their mother bronchi are large in B3a, B6a and B6c in the right lung and in B(1+2)c, B3a, B6a and B6c in the left lung. Most of these correspond to those which many bronchologists felt to be difficult for insertion. In addition, changes in the angles of subsegmental bronchi during respiration are likely to partially account for difficulties encountered during transbronchial approaches.

Aged↗
PubMed1995

The efficacy of the disinfection of bronchoscopes contaminated in vitro with Mycobacterium tuberculosis and Mycobacterium avium-intracellulare in sputum: a comparison of Sactimed-I-Sinald and glutaraldehyde.

The efficacy of Sactimed-I-Sinald and glutaraldehyde was tested against clinical isolates of Mycobacterium tuberculosis (MTB) and Mycobacterium avium-intracellulare (MAI). An in-use method demonstrated that over 10 disinfection cycles, using an auto-disinfector and a contact time of 60 min, MTB was eradicated in 10 out of 10 cycles with Sactimed-I-Sinald and five out of 10 cycles for glutaraldehyde. For MAI, Sactimed-I-Sinald showed a 5 log reduction at a 60 min contact time, which was not seen with glutaraldehyde. Although further evaluation is necessary, Sactimed-I-Sinald appears a promising alternative to glutaraldehyde.

Bronchoscopes↗
PubMed1993

Pediatric bronchography performed through the flexible bronchoscope.

Ten children, ranging in age from 2 months to 16 years, were evaluated by bronchograms performed during bronchoscopy. Nine of the ten children had significant pathology demonstrated by the bronchogram that elucidated findings unclear from other imaging procedures at the time of bronchoscopy. Despite the generally negative opinions about the utility of bronchograms in children, information obtained by bronchography can be quite useful. Bronchography during bronchoscopy proved to be quick, simple, and safe.

Bronchi↗