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Clinical experience of rigid bronchoscopy in single center.

Kim HJ, Kim SW, Lee HY, Kang HH, Kang JY, Kim JS, Kim MS, Kim SS, Kim JW, Yun HG, Kim CH, Kim KH, Moon HS, Cho KJ, Moon SH, Lee SH - Tuberc Respir Dis (Seoul) (2012)

Bottom Line: In all cases of stent, airway obstructive symptom improved immediately.Granulation tissue formation was the most common complication.Rigid bronchoscopic procedures, at least tracheal silicone stenting, should be included in pulmonary medicine fellowship programs because it is a very effective and indispensable method to relieve critical airway obstruction which needs training to learn.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, The Catholic University of Korea School of Medicine, Seoul, Korea.

ABSTRACT

Background: The aim of this study was to analyze clinical situations requiring rigid bronchoscopy and evaluate usefulness of rigid bronchoscopic intervention in benign or malignant airway disorders.

Methods: We retrospectively reviewed 29 patients who underwent rigid bronchoscopy from November 2007 to February 2011 at St. Paul's Hospital, The Catholic University of Korea School of Medicine.

Results: Of the 29 patients, the most frequent underlying etiology was benign stenosis of trachea (n=20). Of those 20 patients, 16 had post-intubation tracheal stenosis (PITS), 2 had tracheal stenosis due to inhalation burn (IBTS) and other 2 had obstructive fibrinous tracheal pseudomembrane (OFTP). Other etiologies were airway malignancy (n=6), endobronchial stenosis due to tuberculosis (n=2), and foreign body (n=1). For treatment, silicone stent insertion was done in 16 cases of PITS and IBTS and mechanical removal was performed in 2 cases of OFTP. In 6 cases of malignant airway obstruction mechanical debulking was performed and silicone stents were inserted additionally in 2 cases. Balloon dilatation and electrocautery were used in 2 cases of endobronchial stenosis due to tuberculosis. In all cases of stent, airway obstructive symptom improved immediately. Granulation tissue formation was the most common complication.

Conclusion: Tracheal stenosis was most common indication and silicone stenting was most common procedure of rigid bronchoscopy in our center. Rigid bronchoscopic procedures, at least tracheal silicone stenting, should be included in pulmonary medicine fellowship programs because it is a very effective and indispensable method to relieve critical airway obstruction which needs training to learn.

No MeSH data available.


Related in: MedlinePlus

Rigid bronchoscopic intervention for other etiologies.
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Figure 3: Rigid bronchoscopic intervention for other etiologies.

Mentions: Among 18 cases of tracheal stenosis caused by endotracheal intubation and inhalation burn, silicone stents were inserted in 16 cases and T-tube insertion was performed in a case for treatment (Figures 1, 2). In a case, insertion of a rigid bronchoscope was impossible since hyperextension of the neck was not secured in anatomical position. Among 16 cases of tracheal stenosis caused by endotracheal intubation, 8 cases underwent tracheostomy including T-tube before stent insertion. In a case, tracheal end-to-end anastomosis was performed but tracheal stenosis reoccurred. In the rest of 7 other cases, silicone stent insertion was implemented as an initial treatment. In two cases of obstructive fibrinous tracheal pseudomembrane, tracheal stenosis was alleviated by completely removing pseudomembrane using a rigid bronchoscope and a forcep. In 6 cases of malignant tumor, tumors were removed by performing snare and mechanical polypectomy using electrocautry through a rigid bronchoscope. In two cases, additional silicone stents were inserted on tracheal stenosis lesions after the removal of tumors. Moreover, in the other two cases of tracheal stenosis due to tuberculosis, balloon dilation and electrocautry was performed. Removal was conducted in a case of foreign body within the trachea (Figure 3).


Clinical experience of rigid bronchoscopy in single center.

Kim HJ, Kim SW, Lee HY, Kang HH, Kang JY, Kim JS, Kim MS, Kim SS, Kim JW, Yun HG, Kim CH, Kim KH, Moon HS, Cho KJ, Moon SH, Lee SH - Tuberc Respir Dis (Seoul) (2012)

Rigid bronchoscopic intervention for other etiologies.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3475459&req=5

Figure 3: Rigid bronchoscopic intervention for other etiologies.
Mentions: Among 18 cases of tracheal stenosis caused by endotracheal intubation and inhalation burn, silicone stents were inserted in 16 cases and T-tube insertion was performed in a case for treatment (Figures 1, 2). In a case, insertion of a rigid bronchoscope was impossible since hyperextension of the neck was not secured in anatomical position. Among 16 cases of tracheal stenosis caused by endotracheal intubation, 8 cases underwent tracheostomy including T-tube before stent insertion. In a case, tracheal end-to-end anastomosis was performed but tracheal stenosis reoccurred. In the rest of 7 other cases, silicone stent insertion was implemented as an initial treatment. In two cases of obstructive fibrinous tracheal pseudomembrane, tracheal stenosis was alleviated by completely removing pseudomembrane using a rigid bronchoscope and a forcep. In 6 cases of malignant tumor, tumors were removed by performing snare and mechanical polypectomy using electrocautry through a rigid bronchoscope. In two cases, additional silicone stents were inserted on tracheal stenosis lesions after the removal of tumors. Moreover, in the other two cases of tracheal stenosis due to tuberculosis, balloon dilation and electrocautry was performed. Removal was conducted in a case of foreign body within the trachea (Figure 3).

Bottom Line: In all cases of stent, airway obstructive symptom improved immediately.Granulation tissue formation was the most common complication.Rigid bronchoscopic procedures, at least tracheal silicone stenting, should be included in pulmonary medicine fellowship programs because it is a very effective and indispensable method to relieve critical airway obstruction which needs training to learn.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, The Catholic University of Korea School of Medicine, Seoul, Korea.

ABSTRACT

Background: The aim of this study was to analyze clinical situations requiring rigid bronchoscopy and evaluate usefulness of rigid bronchoscopic intervention in benign or malignant airway disorders.

Methods: We retrospectively reviewed 29 patients who underwent rigid bronchoscopy from November 2007 to February 2011 at St. Paul's Hospital, The Catholic University of Korea School of Medicine.

Results: Of the 29 patients, the most frequent underlying etiology was benign stenosis of trachea (n=20). Of those 20 patients, 16 had post-intubation tracheal stenosis (PITS), 2 had tracheal stenosis due to inhalation burn (IBTS) and other 2 had obstructive fibrinous tracheal pseudomembrane (OFTP). Other etiologies were airway malignancy (n=6), endobronchial stenosis due to tuberculosis (n=2), and foreign body (n=1). For treatment, silicone stent insertion was done in 16 cases of PITS and IBTS and mechanical removal was performed in 2 cases of OFTP. In 6 cases of malignant airway obstruction mechanical debulking was performed and silicone stents were inserted additionally in 2 cases. Balloon dilatation and electrocautery were used in 2 cases of endobronchial stenosis due to tuberculosis. In all cases of stent, airway obstructive symptom improved immediately. Granulation tissue formation was the most common complication.

Conclusion: Tracheal stenosis was most common indication and silicone stenting was most common procedure of rigid bronchoscopy in our center. Rigid bronchoscopic procedures, at least tracheal silicone stenting, should be included in pulmonary medicine fellowship programs because it is a very effective and indispensable method to relieve critical airway obstruction which needs training to learn.

No MeSH data available.


Related in: MedlinePlus