PubMed · 9370913
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K G Brownlee, D C Crabbe. 1997. Paediatric bronchoscopy.. https://doi.org/10.1136/adc.77.3.272
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Lung cancer is the most common neoplasm of our days. Its mortality has remained invariably high over the last decades and the search for effective preventive and therapeutic strategies is as imperative as ever. Carcinogenesis is a process requiring years until invasive malignancy has developed and hence offers a sufficient period for early detection of (pre-)malignant lesions. Now, tools seem available to achieve this goal: technical refinements advocate a reappraisal of screening methods for lung cancer. Also, apart from conventional diagnostic procedures, which are reviewed in this article, photodynamic and autofluorescence bronchoscopy deserve particular attention. Recent data, showing sensitivity for detection of premalignant lesions increased by factor 1.9 to 2.7 as compared to white light bronchoscopy, suggest markedly improved diagnostic options. With these new instruments, especially when combined with screening programs of high-risk groups, earliest possible diagnosis and successful therapeutic intervention seem a promising concept of reduction of lung cancer mortality.
Its is the task of each medical specialty to develop guidelines for diagnosis and therapies. Examinations done by several specialties should follow a common consensus. A randomized survey at 70 German ENT departments investigated the current position of tracheobronchoscopy and esophagoscopy at each institution. Sixty questionnaires were evaluable. Altogether 8,295 tracheobronchoscopies and 10,404 esophagoscopies were performed. Thirty-six percent of all tracheobronchoscopies and 6% of all esophagoscopies were done with a flexible system. Approximately 58% of all tracheobronchoscopies and 55% of all esophagoscopies were performed for tumor staging. Complications during tracheobronchoscopy occurred in 0.8% of cases and in 0.58% of the esophagoscopies. Using these data an interdisciplinary quality assurance concept was developed for tracheobronchoscopy and esophagoscopy. Current experience has shown that a otolaryngologists in Germany mainly perform rigid tracheobronchoscopy and esophagoscopy. Although endoscopy is mostly done in cases with varied anatomic structures, complications are very rare and comparable to flexible techniques. Greater experience with flexible systems also is to be encouraged in ENT departments.