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At least 19 recordsLinked to original sources
PubMed1981

Complications of bronchoscopy: comparison of rigid bronchoscopy under general anesthesia and flexible fiberoptic bronchoscopy under topical anesthesia.

A prospective study of 4,595 bronchoscopic procedures performed over four years (1975 to 1978) on 2,143 patients with various bronchopulmonary diseases is described. Of the 4,595 procedures, 1,146 were performed with a flexible fiberoptic bronchoscope (Olympus BF-5B2 or BF-B2) under topical anesthesia with tetracaine and procaine, and 3,449 procedures were performed with a rigid bronchoscope under general intravenous anesthesia with hexobarbital (Evipan) using a modified Sanders' technique to ventilate the patients. Complications occurred in 235 procedures (5.1 percent). Major complications that threatened the patient's life and required intensive medical treatment, surgical intervention, or resuscitative measures occurred in 51 procedures (1.1 percent); deaths occurred after 6 procedures (0.1 percent). A comparison of the complications of rigid bronchoscopy and flexible fiberoptic bronchoscopy revealed significantly higher rates of complications of fiberoptic bronchoscopy attributable to toxic effects of tetracaine and of complications of rigid bronchoscopy associated with insufficient general anesthesia. With rigid bronchoscopy, the number of major complications induced by diagnostic manipulations through the bronchoscope and the total number of major complications were significantly higher than with flexible fiberoptic bronchoscopy.

Anesthesia, General↗
PubMedDate not supplied

Fiberoptic bronchoscopy in the diagnosis of lung cancer comparison of pre-and post-bronchoscopy sputa, washings, bruchings and biopsies.

Fiberoptic bronchoscopy (brushings, washings and biopsies) was performed and pre- and post-bronchoscopy sputum cytologies obtained on 70 patients with histopathologically proven lung cancer. Bronchoscopy, with its associated procedures performed in 52 patients with primary bronchogenic carcinoma, was diagnostic in 41 (79%). Of all the various methods of obtaining specimens, bronchial brushing and bronchial biopsy gave the highest percentage yield (67%). However, since brush specimens could be obtained from peripheral lesions under fluoroscopic guidance, a greater number of positive specimens were obtained by this procedure (34) than by forceps biopsy (25), making brushing more useful. Pre- and post-bronchoscopy sputa were positive and thus of value in two cases when brushing and biopsy were both negative. Bronchial washing did not add significantly to the yield of positives and could therefore be eliminated as an unnecessary cost-and time-consuming procedure. Fiberoptic bronchoscopy was not helpful in diagnosing mediastinal tumors (5), lung metastases (7) and bronchial adenomas (6).

Adenoma↗
PubMed1984

Flexible fiberoptic bronchoscopy in the management of tracheobronchial foreign bodies in children: the value of a combined approach with open tube bronchoscopy.

Fifty-two pediatric patients suspected of having a pulmonary foreign body but in whom there was insufficient evidence to warrant open tube bronchoscopy. In 19% of these patients, foreign bodies were found. Twenty-six percent of patients who had previously had foreign bodies removed and who subsequently underwent flexible bronchoscopy for a variety of indications were found to have residual foreign bodies. Clinically unsuspected foreign bodies were found in 1% of 1,054 additional patients who had flexible bronchoscopy for other reasons. The diagnostic use of the pediatric flexible bronchoscope is a safe, definitive, and cost-effective method for the identification of patients with pulmonary foreign bodies when other techniques yield equivocal or negative results. Patients known to have a foreign body should undergo open tube bronchoscopy for foreign body removal.

Bronchi↗
PubMed2002

Pediatric fiberoptic bronchoscopy: Clinical experience with 2,836 bronchoscopies.

OBJECTIVE: To report 21 yrs of experience with pediatric flexible fiberoptic bronchoscopy in infants and children, explore newer applications, delineate potential complications, and make recommendations for its future application. DESIGN: Retrospective review. SETTING: A 20-bed pediatric critical care unit in a tertiary care, university-based children's hospital. PATIENTS: A total of 2,836 pediatric and infant fiberoptic bronchoscopies, performed over a course of 21 yrs, were reviewed. Measurement and MAIN RESULTS: A total of 2,836 children (1,536 girls) were subjected to flexible fiberoptic bronchoscopy. Of those, laryngeal mask airway was incorporated in 92 procedures (3.2%) and general anesthesia was applied in 198 cases (7%). The youngest subject was a 1-wk-old, 600-g, premature infant. The procedure resulted in diagnoses that modified patient care, particularly in tracheostomized infants and those with upper airway obstruction, plastic bronchitis of acute chest syndrome, dyskinetic cilia syndrome, immunocompromised individuals, and those with unexplained chronic cough and recurrent pulmonary infiltrates. Microbiologic and cytologic data from bronchoalveolar lavage helped confirm the diagnoses of pulmonary hemosiderosis and gastroesophageal reflux and validated the presence, or lack of, bacterial or viral pathogens. A total of 21 patients (<1%) experienced life-threatening hypoxemia, prompting termination of the procedure. Laryngospasm or bronchospasm was observed in 17 individuals (<1%) undergoing bronchoalveolar lavage, and 4% of the total population experienced mild nasopharyngeal bleeding. No fatalities were encountered. CONCLUSIONS: Pediatric flexible fiberoptic bronchoscopy is a safe diagnostic and interventional tool, even in young or extremely premature infants. Although the rate of serious complications in this report is low, general anesthetic agents and incorporation of laryngeal mask airway is advocated for severe mucoid impaction, transbronchial biopsy, and chronic pulmonary infiltrates, which may necessitate extensive bronchoalveolar lavage.

Journal Article↗
PubMed2002

Ultrathin bronchoscopy as an adjunct to standard bronchoscopy in the diagnosis of peripheral lung lesions. A preliminary report.

BACKGROUND: The role of the standard bronchoscope as a method of diagnosis of peripheral lung lesions is limited. OBJECTIVES: To evaluate the role of the ultrathin bronchoscope as an adjunct to standard bronchoscopy in the diagnosis of peripheral lung lesions. METHODS: Seventeen consecutive patients with a peripheral lung lesion on chest radiography or chest CT. All patients underwent a bronchoscopic examination with a standard size bronchoscope, and if there was no evidence of endobronchial lesion, these patients were subsequently examined with an Olympus 3C40 ultrathin bronchoscope (external diameter of 3.6 mm). Under fluoroscopic guidance, cytological brushing samples were taken with the ultrathin bronchoscope followed by a reexamination with the standard bronchoscope which followed the same 'pathway' to the lesion established by the 3C40 ultrathin bronchoscope. Transbronchial biopsies (TBB) and cytological samples were taken with the standard bronchoscope. RESULTS: The size of the lesions ranged from 1.5 to 7.0 cm. A positive bronchoscopic diagnosis by TBB was obtained in 11 out of 17 patients (64.7%) and a diagnosis of atypical cells suspicious for malignancy noted in a further 3 patients. For lesions less than 3 cm in size, a positive diagnosis by TBB was achieved in 7 out of 10 of these cases. The lesion was directly visualized with the ultrathin bronchoscope in 4 cases. CONCLUSIONS: Ultrathin bronchoscopy appears to be a useful adjunct to standard bronchoscopy by providing an accurate pathway to the lesion in question. However, further studies with larger patient groups are warranted.

Aged↗
PubMed1984

Bronchoscopy and carcinoma of the esophagus I. Findings of bronchoscopy in carcinoma of the esophagus.

Tracheobronchial involvement frequently occurs in patients with carcinoma of the esophagus. A study of the results of 525 bronchoscopies performed on patients with carcinoma of the esophagus who were evaluated for surgery revealed that abnormalities were found in 33.9 percent. The incidence was highest for those with cervical and upper-third thoracic tumors; however, a significant number of lower-third thoracic and abdominal tumors also showed abnormalities (12.5 and 5 percent, respectively). The incidence was also higher with large tumors, but again, a significant number of apparently small tumors also showed abnormalities. The abnormalities could be broadly classified into two groups: those showing only impingement and those showing actual invasion. Further studies are needed to determine whether the tumors with impingement are resectable.

Adult↗
PubMed1997

Three-dimensional computed tomography bronchoscopy using clinical datasets: a comparison with fibreoptic bronchoscopy.

OBJECTIVE: To assess three-dimensional computed tomography 'bronchoscopic' (3-DCTB) reconstruction of routine CT data as a non-invasive method of airway visualization, and compare it with fibreoptic bronchoscopy (FOB). METHODS: Fourteen datasets were acquired from 13 patients undergoing both FOB and CT examination of the chest. Standard continuous volume CT using 6 mm collimation and clinical FOB techniques were employed. Images were obtained from 3-DCTB reconstructions by segmentation and surface recognition algorithms generating surface rendered 'bronchoscopic views'. These were scored for technical quality and anatomical detail. The most distal bronchi seen in left upper and right lower lobes were recorded for FOB and 3-DCTB. RESULTS: On FOB, the subsegmental bronchi were seen in right lower and in left upper lobe in 10/14 cases and 4/14 cases, respectively. Visualization of the subsegmental airways was not achieved with 3-DCTB, as they could not be identified with confidence. 3-DCTB never achieved a more distal view than obtained by FOB. Using 3-DCT, the right, lower lobe segmental bronchi were seen in 10/14 cases, and lobar bronchus in 14/14 cases (two occluded). In the left upper lobe, 3-DCT showed segmental bronchi in 6/14 cases, lobar bronchus in 11/14 cases (one occluded) and the left main bronchus appeared occluded in 3/14 cases. Overall, technical quality and anatomical detail scores of the carina and proximal bronchi ranked significantly higher than views of segmental bronchi. CONCLUSIONS: 3-DCTB cannot routinely replace FOB for inspection of major and segmental bronchi. Subsegmental bronchi cannot be adequately demonstrated by 3-DCTB using 6 mm collimation datasets.

Adult↗
PubMed1991

Topical nasal anesthesia for flexible bronchoscopy. A comparison of four methods in normal subjects and in patients undergoing transnasal bronchoscopy.

We evaluated nasal anesthesia regimens by comparing, in seven normal men, four drug regimens: 1) 1 percent phenylephrine; 2) 4 percent lidocaine; 3) 1 percent phenylephrine + 4 percent lidocaine; and 4) 5 percent cocaine. After spraying each drug into the anterior nares, vasoconstriction, decongestion, and nasal anesthesia (measured as transnasal depth of nasogastric (NG) tube insertion before discomfort) were assessed. There were no significant differences in NG tube insertion depth between the regimens (p = 0.54). Insertion depth was significantly increased after 10 ml of 2 percent viscous lidocaine were sniffed (p less than 0.004), but again, differences between regimens were not significant (p = 0.051). One hundred bronchoscoped patients received one of the following sprayed into the nose: 1) placebo (P); 2) 1 percent phenylephrine + P; 3) 1 percent phenylephrine + 4 percent lidocaine; or 4) 5 percent cocaine + P. Each patient then sniffed viscous lidocaine. There were no significant differences between regimens for any of the following: 1) nasal resistance to bronchoscope insertion, 2) patient's nasal discomfort, or 3) bronchoscopist's perception of patient discomfort. We conclude that sprayed anesthetics contribute little to nasal anesthesia and any regimen appears acceptable when viscous lidocaine is used.

Administration, Intranasal↗