ISSN:1070-8030    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Abstract:Studies suggest that the maximum yield from bronchoscopy in patients with suspected lung cancer is obtained by a combination of cytology and biopsy samples. Using a simple clinical classification of bronchoscopic appearances, we hoped to predict which samples would be most likely to be positive and reduce workload for pathology departments without compromising diagnostic accuracy. At a district general hospital in England, we studied 655 consecutive patients undergoing a bronchoscopy over a 5‐year period between 1993 and 1998. A total of 301 of these patients had lung cancer. We prospectively classified bronchoscopic appearances and correlated these with the results of cytology and biopsy samples. The following bronchoscopic appearances were classified: 1) tumor in bronchus (TIB); 2) bronchial wall infiltration (BWI); 3) bronchial wall distortion (BWD); 4) normal. Samples taken in order were brushings for cytology, biopsies (a minimum of six), and washings for cytology. In all groups, the biopsy sample was more likely to be positive than cytology. Only cytology was positive in 1.9, 6.4, 5.9, and 11.1% of patients with TIB, BWI, BWD, and normal findings, respectively. In the normal group with a peripheral carcinoma on radiograph, the yield for all samples was 45.1% but only 18.8% with a carcinoma less than 3 cm in diameter. In conclusion, when tumor can be identified by bronchoscopy, only infrequently is cytology necessary for diagnosis. However, cytology samples should be obtained. In our experience, bronchoscopy is not a good diagnostic test in patients with a small peripheral carcinoma.Journal of Bronchology7:295‐300, 2000.TIB, tumor in bronchus; BWI, bronchial wall infiltration; BWD, bronchial wall distortion; FNA, fine needle aspiration; IMS, industrial methylated spirits; CT, computed tomography; BAL, bronchoalveolar lavage.

ISSN:1070-8030    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Abstract:Tracheobronchopathia osteochondroplastica is a rare condition characterized by the development of nodules of cartilage and bone in the submucosa of the trachea and bronchi. The etiology and pathogenesis are unknown; therefore, it can be associated with several diseases. Clinically it has been associated with different signs and symptoms. Chest radiographs, computed tomography, and obstructive spirometry pattern only give diagnostic suspicion. We report our experience in six patients and consider the importance of bronchoscopy in the diagnosis of tracheopathia osteoplastica, and the subsequent biopsy to confirm typical histology.Journal of Bronchology7:301‐305, 2000.TO, tracheobronchopathia osteochondroplastica; FEV, forced expiratory volume in 1 second; FVC, forced vital capacity.

ISSN:1070-8030    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Abstract:Flexible bronchoscopy (FFB) is a well‐established diagnostic and therapeutic tool in pediatric pulmonology. From January 1990 through June 1998, our division performed 574 FFBs. We developed a database for 457 of these procedures (77%) and reviewed it to determine the indications, benefits, and complications of pediatric bronchoscopy. Patient age ranged from 1 to 248 months (median age, 54 months). Common preoperative diagnoses included traumatic brain injury with artificial airways (21.4%), bronchopulmonary dysplasia (12.3%), cerebral palsy (11.8%), underlying neuromuscular disorder (8.8%), tracheostomy and tracheomalacia (22.4%), pneumonia (6.1%), removal of foreign body (4.6%), asthma (8.5%), and cystic fibrosis (1.5%). A total of 78.6% of patients had tracheostomy tubes; 65.4% were mechanically ventilated. Procedures were emergent in 6% of patients, semiemergent in 51% of patients, and routine in 43% of patients. In patients with chronic respiratory failure and artificial airways, mean time between bronchoscopies was 13.5 months. FFB was performed in a bronchoscopy suite in 72% of procedures, in an operating room in 24%, and at the bedside (intensive care unit) in 2.8%. Laryngomalacia, tracheomalacia, and/or bronchomalacia were present in 20.4% of patients, and 9.8% had subglottic stenosis. Other common postoperative diagnoses included suprastomal granuloma at the proximal end of the tracheostomy tube, tracheitis (30.2%), bronchitis (10.7%), suction trauma (5.3%), and/or pneumonia (7.2%). Changes in management resulting from FFB findings included tracheal decannulation (9.4%), change in antibiotic therapy (22.5%), change in continuous positive airway pressure (7.2%), change in tracheostomy tube size (23.2%), and alteration in suction technique (5.3%). A total of 9.2% of patients required surgical intervention, and most of these procedures were for removal of suprastomal granuloma before anticipated decannulation. Complications were rare and included over‐ and undersedation (0.7%), and fever (2.8%). No life‐threatening events occurred, including pneumothorax or hemorrhage. Pediatric FFB is a safe and useful tool in the management of patients with chronic respiratory insufficiency and artificial airways.Journal of Bronchology7:306‐310, 2000.FFB, flexible bronchoscopy; APN, advanced practice nurse; PEEP, positive end‐expiratory pressure; CPAP, continuous positive airway pressure.

ISSN:1070-8030    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Abstract:We report a 72‐year‐old man with massive hemoptysis, whose bleeding was controlled successfully using a modified Dynamic stent and cyanoacrylate glue. The bleeding site was the distal portion of the left main bronchus, with invasion by non‐small cell lung cancer. An endotracheal tube with a movable blocker was used for unilateral mechanical ventilation. Oxycellulose cotton was pressed into the left main bronchus under bronchoscopic vision, which achieved provisional arrest of the hemorrhage. A cross‐stripe web of nonabsorbable surgical suture was formed on the left‐side distal end of the Dynamic airway stent, and was introduced into the airway to prevent the migration of the oxycellulose cotton. However, the cotton softened spontaneously with secretion, and was eliminated accidentally by transbronchial suction. Cyanoacrylate glue—the next filling material—was then injected through the suture web under bronchoscopic vision. Hemorrhage recurred as a result of insufficient plombage, and another injection of cyanoacrylate glue was needed. The patient was removed from mechanical ventilation 2 months after admission, and no hemorrhage was observed after the second injection of cyanoacrylate glue.Journal of Bronchology7:311‐315, 2000.

ISSN:1070-8030    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Abstract:A 50‐year‐old woman presented with exacerbation of bronchial asthma, which had been diagnosed 2 years earlier. During that period, the patient was under therapy with inhalers and antiasthmatic drugs including corticosteroids. Because the clinical symptoms persisted despite therapy, she underwent bronchoscopy, which showed foreign body aspiration. Histologic examination indicated organized intrabronchial granuloma. The foreign body (a fish bone) was removed with open thoracotomy and bronchotomy, and the patient recovered completely from the symptoms of the previous 2 years.Journal of Bronchology7:316‐319, 2000.FVC, forced vital capacity; FEV1, forced expiratory volume in 1 second; TLC, total lung capacity; FRC, functional residual capacity; RV, residual volume.

ISSN:1070-8030    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Abstract:Two cases of small occult carcinomas of the lung (greatest dimension on the bronchial surface, <10 mm) at stage TIS were referred for treatment. Repeat biopsies of these carcinomas within 2 weeks during fluorescent endoscopy revealed microinvasion below the basement membrane (T1). These cases illustrate that even small occult bronchogenic carcinomas may exhibit contiguous areas with and without infiltration below the basement membrane, with prognostic and therapeutic implications. They also suggest that accurate staging of very early lung cancer may require multiple endobronchial biopsies.Journal of Bronchology7:320‐323, 2000.CIS, carcinomain situ;PDT, photodynamic therapy; COPD, chronic obstructive pulmonary disease.

ISSN:1070-8030    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:1070-8030    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:1070-8030    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:1070-8030    

出版商:OVID    

年代:2000

数据来源: OVID