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At least 775 records · Page 43Linked to original sources
PubMed1999

[Complications of interventional bronchoscopy].

Interventional bronchoscopy associates different techniques; rigid bronchoscopy under general anaesthesia, the utilisation of the laser, cryotherapy, electrocoagulation and the positioning of endobronchial prostheses. It it used most often in those patients whose respiratory reserve is precarious. It is important to recognise the potential complications of these different techniques in order to prevent them as far as possible. This article also reviews the principal complications which are linked to each technique which has previously been described.

Anesthesia↗
PubMed2000

[Autofluorescence bronchoscopy: Laser imaging fluorescence endoscope].

The LIFE (laser imaging fluorescence endoscope) system has been shown to increase the diagnosis of dysplasia and carcinoma in situ when used in combination with conventional bronchoscopy. A doubling to tripling of the rate of early centrally located lung cancer diagnosis is a step forward in the detection of early lung cancer. A wide spectrum of interventional procedures for endoluminal treatment of lung cancer in functionally inoperable patients makes it possible to treat this group of patients. The LIFE system works without exogenous sensitisers, with no increase in complications as compared to conventional bronchoscopy, and takes only a little longer in examination time.

Bronchitis↗
PubMed2001

[Virtual bronchoscopy: a new non-invasive diagnostic method in pulmonology].

Virtual reality (3 dimensional modelling of the human body) has developed as a convergence of advancing digital imaging modalities and computer graphics technologies. With this method endoscopic simulations of cavitary organs are feasible. Virtual bronchoscopy was initially described in 1993. The authors selected patient with previously detected stenosis of the trachea or the main bronchi with bronchofiberscope. They performed targeted, thin-slice helical computer tomography of the lesions. These data were transferred to a workstation and the virtual endoscopic models of the airways were generated using dedicated software. Based on cases the authors describe their preliminary experience with the method. The findings were compared with those of bronchofiberscopy. Analyzing these results and the literature the potential clinical applications of virtual bronchoscopy are discussed.

Adult↗
PubMed2001

Functional evaluation before and after interventional bronchoscopy in patients with malignant central airway obstruction.

Rigid or flexible interventional bronchoscopy is increasingly accepted for treating central tracheal or bronchial obstruction caused by incurable pulmonary malignancy. Immediate and sustained symptomatic relief and improvement of quality of life can be offered to patients suffering from dyspnoea and facing death by suffocation. Selection of patients based on functional aspects is of central importance for success in endoscopic treatment. A thorough workup is conducted with close cooperation between the various specialists involved in thoracic oncology (pulmonologist, oncologist, radio-oncologist, thoracic and upper airway surgeon). Careful history taking, clinical examination, pulmonary function testing (PFT) and radiologic imaging are needed to assess the general condition of the patient and give information of type and stage of the underlying malignancy. In eligible patients, timing and method of the intervention depend on the acuteness of the presentation and the endoscopic assessment of the lesion responsible for the obstruction. Regular postinterventional follow-up should be conducted by the patient's doctor and consist of clinical examination, PFT and chest radiography. Close cooperation with the specialist centre is necessary to refer patients for repeat bronchoscopy and management of suspected recurrences or complications.

Airway Obstruction↗
PubMed2001

[Virtual bronchoscopy: a new tool of non-invasive imaging of airway inner surface based on standard spiral computed tomography of the chest].

The aim of the study is to assess the new method of radiological imaging of the inner surface of a tracheobronchial tree in order to determine to what extend it can replace the standard bronchoscopy. The spiral CT examinations of 43 patients with hilar lung tumor in virtual mode had been reconstructed retrospectively and compared to the results of fiberoptic bronchoscopy. There was a significant correlation between both methods to reveal stenoses or occlusions of airway lumen. Virtual endoscopy turned out to be an unsatisfactory method in the visualisation of mucosal changes.

Adult↗
PubMedDate not supplied

Flexible fibreoptic bronchoscopy in Basra, Iraq: a 20-month experience.

This prospective study represents our experiences in using fibreoptic bronchoscopy (FOB) in the evaluation of different thoracic lesions. Over a 20-month period, 203 patients (151 males and 52 females) (age range: 15-100 years) underwent bronchoscopies. The patients had a wide range of symptoms and/or radiographic abnormalities. The majority had cough and shortness of breath; haemoptysis was a common symptom. In all, 148 patients had neoplasms and 55 had non-neoplastic lesions. The most common malignancy was bronchogenic carcinoma (91 confirmed, 33 suspected). Other neoplasms included pulmonary metastases and mediastinal tumours. The non-neoplastic chest lesions included pulmonary tuberculosis, pulmonary hydatid cyst, lung abscess and resolving chest infection and chronic bronchitis. FOB was most useful in the diagnosis of bronchogenic carcinoma (positive diagnostic yield of 73%). It was least useful in diagnosing mediastinal tumours.

Adolescent↗
PubMedDate not supplied

Bronchoscopy in newborns with esophageal atresia.

The aim was to evaluate the influence of rigid laryngotracheo-bronchoscopy in newborns with oesophageal atresia (OA) and tracheoesophageal fistula (TOF) in preventing complications, improving diagnosis and surgical treatment. Among 76 consecutive newborns, received in the Paediatric Intensive Care Unit (PICU) from January 1990 to September 2001 with prenatal o perinatal suspected OA, forty-five had one or more other congenital anomalies. They were divided in I Montreal's risk group for 73.7% (56) and in the II one for 26.3% (20). Endoscopic procedure was performed in the operating room with Storz's rigid ventilating bronchoscope just before surgery, in all babies. With bronchoscopic examination we were able to identify the level, number and size of TOF and to visualise anatomical variants in 76 children. 15 children with OA had a gasless abdomen, but an upper pouch fistula was found only in three cases. In another four cases bronchoscopy confirmed the diagnosis of an "H" fistula and cervical surgical approach was established. One case had only oesophageal stenosis. 56 patients had fistula in lower pouch and in the last 38 cases we proceeded with selective transtracheal fistula incannulation and then we provided gastric drainage. One quadriforcation, 2 triforcations, 3 aberrant right upper lobe bronchi, 1 congential subglottic stenosis and 1 associated with a congenital subglottic stenosis and 1 left main bronchus agenesia were detected. No complications were correlated to the procedure and no babies had early pneumonia. Continuous feeding was achieved in 70 out of 76 patients: 46 primary anastomosis with 12 staged repairs (OA I and II type long gap), 4 resections of TEF, 8 oesophagocoloplasty. Nine babies (11.8%) did not survive. Clinical follow-up was possible in all the survivors. Mortality rate in the high-risk patients with OA remains high because of the many complications that may occur. Tracheal endoscopy is useful in improving the diagnostic approach and to prevent pulmonary complications. Fistula incannulation minimizes the risk of gastric distension and its detrimental effect on ventilation, helping the surgeon to identify TEF easily and quickly. Moreover, the endoscopic approach offers obvious advantages for the anaesthesiologist and the surgeon and has proven, in our experience, to be effective.

Bronchoscopy↗
PubMed1976

[Severe asphyxiant hemoptysis. Bronchoscopy under extracorporeal circulation].

The authors report a case of bronchoscopy made necessary by severe hemoptysis in a young man with very severe respiratory distress. Bronchoscopy was carried out under excellent conditions thanks to respiratory assistance supplied by partial femoro-femoral extra-corporeal circulation. The interest and limits of this method are discussed.

Adult↗
PubMed2003

[Interventional bronchoscopy].

BACKGROUND: In Norway, laser treatment of tumours in lower airways started in 1985. MATERIAL AND METHODS: A survey is given of the 192 patients treated by therapeutic bronchoscopy during the last four years at Rikshospitalet University Hospital. 97 patients with malignant disease and 95 with benign lesions have been treated by either laser, stent or both. RESULTS: The treatment results are judged from treatment intention. In both groups improvement was obtained in 80-90 % of patients. Five carcinoids were eradicated by laser, and three early cancers of squamous cell type. Two patients in the malignancy group died in connection with the treatment. INTERPRETATION: Therapeutic bronchoscopy has become a necessary treatment for a small, but varied group of patients.

Adult↗
PubMed2003

[Tolerance of fiberoptic bronchoscopy by self-administered questionnaire: in the words of the patients].

INTRODUCTION: Fibreoptic bronchoscopy is currently undertaken by the majority of respiratory physicians, but under varying conditions. Though complications are rare the tolerance of this examination is sometimes poor, particularly when it is performed under local anaesthesia. The undesirable effects may reduce the value of the examination as well as causing discomfort for the patient. METHODS: A prospective study of the tolerance of the endoscopic examination was made on 100 consecutive patients by self-administered questionnaire. RESULTS: There were no major and 7 minor complications (7%). 45% of the patients were anxious but the experience of the operator tended to reassure them (p=0.07). 30% of the patients reported some pain, which tended to be exacerbated by anxiety (44% vs 18%, p=0.008) and the supine position (57% vs 43%, p=0.047). 37% of patients reported nausea, and 50% dyspnoea, without any significant predictive factor. 79% would agree to a repeat examination under the same conditions and 92% said that they had received information appropriate to the examination undergone. CONCLUSION: The tolerance of fibreoptic bronchoscopy under local anaesthesia is poor and perhaps overestimated by respiratory physicians. Patient information is essential. A national enquiry could lead to the standardisation of techniques.

Anesthesia, Local↗
PubMed1992

[Diagnostic role of fiberoptic bronchoscopy for mycobacterial diseases].

From 1981 to 1991, 5,572 patients underwent bronchoscopic examination, in this series 3,754 patient's samples were sent for determination of mycobacterial isolation. In the 506 samples, mycobacterial bacilli were detected with smear or culture. In the low tuberculous incidence area like northern part of America, many reporters supported the opinion that routine bronchial aspirate detection for tuberculosis was not cost-effective. Inversely, in the high tuberculous incidence area like Hong Kong, M. lp et al. claimed the usefulness of routine bronchial aspirate examination for mycobacterial bacilli. Japan was regarded as moderate tuberculous incidence area. We review a ten-year experience with fiberoptic bronchoscopy for mycobacterial isolation. Our results suggest that in an area with a moderate prevalence of tuberculosis, bronchoscopic examination for mycobacterial disease is useful in the selected hospitals for the selected cases. In Japan, the smear positive prevalence has been on the increase from 1982. We estimate that the Japanese popularization of fiberoptic bronchoscopy may influence a part of the Japanese epidemic statistical analysis of mycobacteriosis.

Adolescent↗
PubMedDate not supplied

[Anesthesia for bronchoscopy].

Fiberoptic bronchoscopy is a valuable diagnostic and therapeutic procedure in many clinical situations and is relatively simple to perform with the proper techniques. Local anesthetic techniques are often preferable for bronchoscopy since the examination is mostly undertaken as outpatient procedure. When the topical anesthesia is supplemented with light sedation, the procedure is easier and more acceptable to the patient. We describe a very efficient technique based on the transtracheal injection of a minimal amount of lidocaine directly on the upper airway mucosa, producing adequate anaesthesia. The method is easy to perform and safe.

Anesthesia, Local↗
PubMed1992

[Prophylactic use of antibiotics for fever following fiberoptic bronchoscopy and bronchography].

To evaluate the effect of bacampicillin hydrochloride on fever following fiberoptic bronchoscopy and bronchography, we conducted multi-institutional randomized study. In bronchographic examinations, the rise of body temperatures in the bacampicillin group (0.82 +/- 0.13 degrees C: mean +/- SE) was significantly smaller than that in the control group (1.39 +/- 0.25 degrees C) on the second day of examination. Bacterial infection may contribute to the rise of temperature on the day following bronchography, but no pneumonia or sepsis was observed. There was no differences in the rise of body temperature on the first, third or fourth day. In fiberoptic bronchoscopic examinations, there was no difference between the two groups. We conclude that there is no clinical indication of the value of prophylactic use of antibiotics in either fiberoptic bronchoscopy or bronchography.

Adult↗
PubMed2003

[Autofluorescence bronchoscopy for early localization of lung cancer].

Autofluorescence bronchoscopy (AFB) is more sensitive than conventional white light bronchoscopy in localizing small premalignant and early malignant lesions involving the large airways, particularly when applied to high- risk patients. The applications of AFB include localization of roentgenographically occult lung cancer, detection of synchronous tumors, estimation of the extent of field cancerization,chemoprevention studies, etc. This review deals with the history of AFB and recent clinical studies in AFB and discusses its current value as a research tool.

Bronchoscopy↗
PubMed2003

[10-year experience in flexible bronchoscopy in pediatric patients].

BACKGROUND: Approximately a decade ago, pediatric Flexible Bronchoscopy (FB) was introduced in Chile, after being used for several years in adults. AIM: To describe our clinical experience in FB in a ten years period. PATIENTS AND METHODS: Records of procedures done between January 1993 and September 2002 at the Pediatric Service of the Catholic University Hospital, were retrospectively reviewed. We evaluated the clinical indications for the procedures in relation to patient's age and the correlation between indications and FB findings. RESULTS: A total of 700 procedures were performed during the period, 59% in men and 53% in patients younger than 1 year. Seventy seven percent of procedures were done in an examination room, using a nasal approach. The main indication was visualization of the airway (49%). The most common clinical diagnosis, in descending order were: atelectasis, stridor and etiologic study of pneumonia by bronchoalveolar lavage (BAL). In children younger than 6 months the most common clinical diagnosis was stridor, followed by atelectasis. The main diagnosis in the whole sample, reached by FB was atelectasis secondary to mucous plug. In children younger than 6 months, the main diagnosis was laryngomalacia. A positive microbial culture was obtained in 43% of patients in whom BAL was done. Complications were uncommon (5%) and mostly mild. In 2.3% of cases, these were severe, such as bronchospasm and need for mechanical ventilation. Severe complications were observed in patients younger than 3 months with severe stridor or in children with cancer, who required FB and BAL. CONCLUSIONS: Flexible bronchoscopy is a safe and useful procedure in pediatric patients.

Bronchoalveolar Lavage↗
PubMed1992

Oxygen desaturation during fiberoptic bronchoscopy.

A prospective study was performed to detect oxygen saturation (SaO2) during and following fiberoptic bronchoscopy (FOB) in 50 patients. Twenty-five patients (group 1) underwent the procedure without and 25 (group 2) with supplemental oxygen. The SaO2 declined from the baseline value of 96.4% to 92.08% in group 1 and to 94.88% in group 2 after bronchoscopy alone. The decline was also noted when biopsy and broncho-alveolar lavage (BAL) were performed, the lowest values being recorded during BAL. The result showed that the fall in SaO2 in group 2 was significantly less than that in group 1 (P < 0.05). SaO2 returned to baseline values after a mean time of 4.9 minutes in group 1 and 2.4 minutes in group 2, demonstrating the benefit of supplemental oxygen.

Adult↗
PubMed2004

Comparative study of lung cytologic features in normal rhesus (Macaca mulatta), cynomolgus (Macaca fasicularis), and African green (Chlorocebus aethiops) nonhuman primates by use of bronchoscopy.

Invasive bronchoscopy and bronchoaveolar lavage (BAL) fluid collection represents an important tool in studies of the respiratory system of nonhuman primates. Bronchoscopy and BAL fluid collection was performed on groups of rhesus (Macaca mulatta) and cynomolgus (Macaca fasicularis) macaques and African green monkeys (Chlorocebus aethiops), and the resulting comparative lavage cytologic features are described. Analysis of the BAL fluid did not reveal significant differences among species with respect to total cells recovered or differential cellular composition. This description of the method used to lavage the nonhuman primates and the resulting lung cytologic findings provide important comparative data for three species commonly used in biomedical research.

Animals↗
PubMed2004

Bronchoscopy in adults at a tertiary care centre: indications and complications.

Fibreoptic bronchoscopy (FOB) helps in visualisation of the endobronchial tree. Fibreoptic bronchoscopies were done in 429 cases between January 1999 and January 2000 [322 men (75.1%) and 107 women (24.9%)]. Patients were between 12 and 89 years of age (mean+/- SD = 49 +/- 15.1 years). Of which, 196 (45.7%) had lung cancer and 233 (54.4%) had non-malignant disease [Tuberculosis (TB) 26, miliary TB 16, non-resolving pneumonia 29, atypical pneumonia 10, bronchiectasis 11, aspergillosis 12, sarcoidosis 17, interstitial lung disease (ILD) 20, haemoptysis with normal chest x-ray 13 and miscellaneous 79]. In this series of 429 patients a significant number of patients (n = 127) presented with fever (38 malignant and 89 non-malignant disease, p < 0.0001), 137 had haemoptysis (74 malignant and 63 non-malignant disease, p < 0.01), 89 had chest pain (61 malignant and 28 non-malignant disease, p < 0.0001) and 29 patients presented with complaint of anorexia (21 malignant and 8 non-malignant disease, p < 0.003). High prevalence of lung lesions in the right upper lobe [10.4% (43 of 411)] and left main bronchus [12% (49 of 411)] was observed. Left upper lobe showed 8.7% (36 patients) lesions and right middle lobe showed 5.5% (23 patients) lesions. In 143 (34.8%) patients, FOB findings were normal. Out of 407 patients, FOB was suggestive of necrotic/nodular growth in 159 patients (39.1%), infiltrative growth in 8 patients (1.9%), and extrinsic compression was found in 39 patients (9.6%). In 143 patients (35.2%) no endobronchial growth was seen. Bronchial biopsy (BB) was performed in 162 (37.8%) patients, transbronchial lung biopsy in 56 patients (13.1%), bronchial washing for cytology in 350 patients (81.5%), bronchial washing for AFB in 302 patients (70.3%), bronchial washing for culture in 67 patients (15.6%), bronchial washing for fungus in 64 patients (14.9%) and Pneumocystis carinii infection was looked for in 6 patients (1.4%). Postbronchoscopy complications were recorded as follows: Early termination of FOB due to decreased O2 saturation in 10 cases (2.4%), postbiopsy bleeding in 5 cases (1.2%), post FOB fever in 5 cases (1.2%), chest pain in 7 patients (1.7%) and pneumothorax occurred in 2 patients (0.5%). FOB performed in outpatient setting is a useful and safe modality. Most patients in whom FOB was done in the present setup had suspected lung cancer. No major complications were encountered.

Adolescent↗