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1.
Zhonghua Jie He He Hu Xi Za Zhi ; 45(1): 88-94, 2022 Jan 12.
Artigo em Chinês | MEDLINE | ID: mdl-35000312

RESUMO

In the last decade, interventional pulmonology has developed rapidly, and gradually become a mature subspecialty in modern respiratory medicine, playing a more and more important role in the diagnosis and treatment of respiratory diseases. Especially in recent years, with the development of the related technology, various new technologies of interventional pulmonology came out and are gradually applied to chronic respiratory diseases which were mainly treated with drugs before, greatly expanding the application field of interventional pulmonology. Here, we reviewed the new progress and up-to-date research achievements of interventional pulmonology from 2020 to 2021.


Assuntos
Pneumologia , Broncoscopia , Pesquisa
2.
In Vivo ; 36(1): 350-354, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34972733

RESUMO

BACKGROUND/AIM: The directions of distal and proximal airway stumps were different in Y-sleeve lobectomy. This difference might make Y-sleeve lobectomy a difficult procedure. In this article, we present our surgical techniques and analyse short-term outcomes of Y-sleeve lobectomy. PATIENTS AND METHODS: Right middle and lower, left lower, and left lower and lingular segment sleeve lobectomies are categorized in Y-sleeve lobectomy. We retrospectively investigated the clinical courses of 17 patients who underwent Y-sleeve lobectomy from January 2017 to December 2020. RESULTS: No treatment-related deaths occurred. One patient developed a bronchopleural fistula. Four patients developed pneumonia and were cured by repeated bronchoscopies and antibiotic therapy. Three patients had retention of pleural effusion, and two had prolonged air leakage. One patient had empyema after prolonged air leakage and was cured by thoracic drainage and antibiotic therapy. CONCLUSION: A major complication was observed only in one patient. Y-sleeve lobectomy is a reliable surgical method to avoid pneumonectomy.


Assuntos
Neoplasias Pulmonares , Pneumonectomia , Brônquios , Broncoscopia , Humanos , Neoplasias Pulmonares/cirurgia , Estudos Retrospectivos
3.
J Int Med Res ; 50(1): 3000605211068309, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35023372

RESUMO

General anaesthesia with a muscle relaxant is usually performed for rigid bronchoscopy (RB), but ventilation is challenging due to large amounts of leakage. Optiflow™ supplies 100% humidified, warmed oxygen at a rate of up to 70 l/min and this high flow rate may overcome the leakage problem. This case report describes four patients that were scheduled for RB. The lung lesions were all located below the carina, so a bronchial tube was inserted under general anaesthesia. Once a large amount of leakage was confirmed by manual ventilation, Optiflow™ was connected to the bronchial tube (flow rate, 70 l/min). All of the ports of the bronchoscopy were left open to prevent the risk of outlet obstruction. Oxygenation was well maintained with stable vital signs throughout the procedures, which took up to 34 min without airway intervention. There were no occurrences of cardiac arrhythmia or changes in the electrocardiograms. Respiratory acidosis recovered after emergence, which was confirmed by arterial blood gas analysis in all cases. Apnoeic oxygenation using Optiflow™ was applied successfully during RB. Applying Optiflow™ could make cases of difficult ventilation during RB much easier for the anaesthetist. Larger studies need to demonstrate the efficacy and safety of this technique.


Assuntos
Insuflação , Administração Intranasal , Apneia , Broncoscopia , Humanos , Respiração Artificial
4.
Bratisl Lek Listy ; 123(1): 66-71, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34967661

RESUMO

BACKGROUND AND METHOD: To determine the current situation and trends in bronchology in the Czech Republic (CR), a questionnaire survey has been conducted by the Czech Pneumological and Phthisiological Society (CPFS). RESULTS: In 2020, 158 bronchoscopists conducted 26,700 BRS procedures, 927 of them were rigid. 2,869 procedures were done under general anaesthesia. Of diagnostic methods, the use of endobronchial ultrasound (EBUS) is rising, being available in 35 % BRS facilities in 2020. Interventional bronchology procedures are conducted in 17 facilities and 1,517 were executed in 2020. The numbers of cryocauterizations and stenting are growing. In the questionnaire we asked also about biomarkers of lung carcinoma that are examined at 47 out of 49 facilities. Since 1975 when 11,194 bronchoscopies were conducted in the CR, their numbers increased to 33,282 in 2009, then dropping slightly to 26,700 in 2020. At present, 254 bronchoscopies are conducted per 100,000 inhabitants in a year. CONCLUSIONS: Based on the BRS survey in 2020 it can be concluded that Czech bronchology is developing in the right direction and is well equipped with both, staff and technical devices. We are adopting new methods without delays and we expand the use of those working well (EBUS) (Tab. 4, Ref. 13).


Assuntos
Broncoscopia , Neoplasias Pulmonares , República Tcheca/epidemiologia , Humanos , Inquéritos e Questionários
5.
Pediatr Pulmonol ; 57(1): 185-192, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34647686

RESUMO

This study evaluates the whole airway abnormalities of long-term treated late-onset Pompe disease (LOPD) patients, with interventions using the flexible bronchoscope (FB). As a retrospective study, we follow up with our five LOPD patients treated with Myozyme from 2012 to 2021 regularly, but with a focus on the whole airway abnormalities of these patients visualized through FB. The long-term clinical outcomes and relevant airway symptoms were assessed. Pulmonary function test and polysomnography were performed to evaluate the degree of respiratory compromise. All patients in the study had varying degrees of airway collapsibility, pulmonary complications, sleep apnea syndrome, and facial anomalies. Pulmonary function could preserve after Myozyme treatment, but potential deterioration thereafter. This is the first study that focuses on airway abnormalities and pulmonary complications in long-term treated LOPD patients using FB. Despite years of Myozyme treatment, we still observed airway abnormalities in these patients. In our series, the pulmonary complications seem more obvious than those observed in patients with infantile-onset Pompe disease, which might be related to the late diagnosis and treatment. We might recommend that FB could provide dynamic evaluation and interventions of airway abnormalities simultaneously. Early diagnosis of respiratory dysfunction is a critical prognostic factor of the long-term outcome of treated LOPD patients.


Assuntos
Doença de Depósito de Glicogênio Tipo II , Síndromes da Apneia do Sono , Broncoscopia , Doença de Depósito de Glicogênio Tipo II/complicações , Doença de Depósito de Glicogênio Tipo II/diagnóstico , Doença de Depósito de Glicogênio Tipo II/tratamento farmacológico , Humanos , Polissonografia , Estudos Retrospectivos
10.
11.
Zhonghua Jie He He Hu Xi Za Zhi ; 44(12): 1071-1077, 2021 Dec 12.
Artigo em Chinês | MEDLINE | ID: mdl-34915620

RESUMO

Objective: To evaluate the effectiveness and safety of the robotic assisted bronchoscope system for localizing and removing the spring coils that placed in the peripheral lung of beagle dogs. Methods: The study was conducted from June 18th to June 20th, 2021. Metallic lung coils were placed as the simulated lesions to the periphery of the lungs of two adult male beagle dogs using a bronchoscope under general anesthesia. The navigation path was planned by the navigation function that built in the robotic bronchoscope system. After training, the doctors operated the robotic bronchoscope system to locate and remove the coils from the lung. The navigation success rate, sampling success rate, position of the coil, navigation time, sampling time, and operation time were evaluated. The damage to the airway mucosa during the operation and the vital signs of the beagles during and post-operation were accessed. Chest computerized tomography (CT) was performed post-operation to detect if there were complications such as pneumothorax and bleeding. Results: A total of 12 spring coils were successfully inserted into the two beagles. All the navigation paths of the simulated lesions were successfully planned. The navigation success rate was 12/12. The navigation time was (43.9±19.8) seconds. The distance between the tip of the flexible endoscope arm and the target point measured by the navigation system was (6.93±2.15) mm. The locations of the simulated lesions were distributed in the 6th-8th generation of bronchi. The sampling success rate was 12/12. The sampling time was (42.4±11.3) seconds. There was no pneumothorax or mediastinal emphysema after the placement of the coil. The vital signs of the beagle dogs were stable throughout the operation, and no operation-related or postoperative complications occurred. Conclusions: The robotic bronchoscope system can be used to locate and remove the spring coils from the peripheral lung of beagle dogs, and the procedure is simple and safe. It suggests that the robotic bronchoscopy system has great clinical significance in the sampling and diagnosis of peripheral lung lesions.


Assuntos
Broncoscopia , Procedimentos Cirúrgicos Robóticos , Animais , Broncoscópios , Cães , Pulmão/diagnóstico por imagem , Pulmão/cirurgia , Masculino , Projetos Piloto
13.
Rev Assoc Med Bras (1992) ; 67(12): 1832-1838, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34909958

RESUMO

OBJECTIVE: Endobronchial ultrasound-guided transbronchial needle aspiration has been successfully applied in both diagnosis and staging of mediastinal and hilar lymphadenopathies and masses, especially in malignant cases. However, the optimal procedure of Endobronchial ultrasound-guided transbronchial needle aspiration to further increase diagnostic yield and minimize processing complexity remains controversial. This study aims to compare aspiration biopsy (Endobronchial ultrasound-guided transbronchial needle aspiration) and non-aspiration biopsy (Endobronchial ultrasound-guided transbronchial needle capillary sampling) in terms of sample adequacy, diagnosis, and quality in malignant cases. METHODS: Between March 2018 and June 2020, Endobronchial ultrasound-guided was performed sequentially on patients with mediastinal and/or hilar lymph nodes that were considered malignant. Each lymphadenopathy was sampled with and without aspiration. A single-blinded pathologist evaluated the samples. RESULTS: A total of 84 lymph nodes evaluations of 51 patients were included. Most samples were taken from the right lower paratracheal lymph nodes (n=27, 32.2%) and subcarinal LN (n=21, 25%). The mean size of the lymph nodes was 21.21±8.257 (8-40) mm. The agreement between the two procedures in terms of sample adequacy and diagnostic yield was 69.1% (95%CI 58-78.7, p=0.076). In addition, according to the goodness-of-fit statistics, the kappa values were 0.255 (p=0.015) and 0.302 (p=0.004) for sample adequacy and diagnostic yield, respectively. There was no difference between the two procedures in relation to complications. CONCLUSION: Although the agreement between the two procedures is weak, Endobronchial ultrasound-guided transbronchial needle capillary sampling can be performed with less personnel, without reducing diagnostic yield and tissue adequacy. These findings can assist clinicians in determining the optimal procedure for Endobronchial ultrasound-guided.


Assuntos
Neoplasias Pulmonares , Broncoscopia , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Linfonodos/diagnóstico por imagem , Metástase Linfática , Mediastino/diagnóstico por imagem
15.
Pan Afr Med J ; 40: 153, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34970395

RESUMO

Congenital tracheobronchomegaly, also known as Mounier Kuhn Syndrome (MKS) is a rare respiratory disorder characterized by dilatation of the trachea and bronchi. We report a case of a 28-year-old male of African descent in Zambia, who presented with a history of chronic productive cough and repeated chest infections since childhood. He had been treated numerous times for lower respiratory tract infections, and had received empiric tuberculosis (TB) treatment based on chest radiograph findings, despite negative sputum microscopy and molecular tests for TB. Investigations revealed normal baseline blood results and sputum results. He however, had markedly increased levels of serum immunoglobulin E, and spirometry showed an obstructive pattern with significant post bronchodilator improvement. High-resolution computed tomography scan revealed tracheal dilatation, extensive bilateral bronchiectasis and tracheal and bronchial diverticula. The latter were also seen on bronchoscopy, confirming the diagnosis of Mounier-Kuhn syndrome. The patient was treated with combined inhaled corticosteroids and bronchodilators, as well as chest physiotherapy for mucus clearance, which led to improvement in his symptoms. Our case highlights how in low-resource settings, chronic lung diseases, particularly bronchiectasis, are often clinically and radiologically mistaken for and presumptively treated as TB (or its sequelae). Mounier-Kuhn syndrome, albeit rare, should be considered in the differential diagnosis of patients with recurrent lower respiratory tract infections or bronchiectasis. Multidisciplinary team meetings can help in the diagnosis of rare lung diseases.


Assuntos
Bronquiectasia , Traqueobroncomegalia , Adulto , Brônquios , Broncoscopia , Criança , Humanos , Masculino , Traqueia , Traqueobroncomegalia/diagnóstico
16.
J Int Med Res ; 49(12): 3000605211065370, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34939439

RESUMO

Plastic bronchitis (PB) is a rare and potentially fatal disease characterized by acute progressive dyspnea caused by bronchial casts in the bronchial tree. We analyzed two children with asthma and PB who presented with high fever, cough and dyspnea. Both cases showed acute onset and rapid disease progression. Laboratory examination revealed that both children were infected with influenza A virus. Emergency fiberoptic bronchoscopy was performed within 20 hours of admission. Immediately after removing the bronchial casts, their dyspnea symptoms improved significantly, and they recovered after comprehensive treatment with antiviral drugs, antibiotics and glucocorticoids. When children with asthma have acute progressive and difficult-to-relieve dyspnea after infection with influenza A virus, clinicians should be aware of the possibility of PB and perform bronchoscopy as soon as possible to facilitate early diagnosis and treatment and improve patient prognosis.


Assuntos
Asma , Bronquite , Vírus da Influenza A , Influenza Humana , Asma/complicações , Asma/tratamento farmacológico , Bronquite/complicações , Bronquite/diagnóstico , Bronquite/tratamento farmacológico , Broncoscopia , Criança , Humanos , Influenza Humana/complicações , Influenza Humana/diagnóstico , Influenza Humana/tratamento farmacológico , Plásticos
17.
BMJ Case Rep ; 14(11)2021 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-34799393

RESUMO

Patients with SARS-CoV-2 pneumonia can suffer from pneumothorax and persistent air leak (PAL). The pneumothorax occurs with or without pre-existing lung disease. PAL refers to air leak lasting more than 5-7 days and arises due to bronchopleural or alveolopleural fistula. The management of PAL can be challenging as a standard management guideline is lacking. Here we present the case of a 42-year-old smoker with COVID-19 who presented to the hospital with fever, cough, acute left-sided chest pain and shortness of breath. He suffered from a large left-sided pneumothorax requiring immediate chest tube drainage. Unfortunately, the air leak persisted for 13 days before one-way endobronchial valve (EBV) was used with complete resolution of the air leak. We also review the literature regarding other cases of EBV utilisation for PAL in patients with COVID-19.


Assuntos
COVID-19 , Enfisema , Pneumotórax , Adulto , Broncoscopia , Humanos , Masculino , Pneumotórax/diagnóstico por imagem , Pneumotórax/etiologia , Pneumotórax/terapia , SARS-CoV-2
18.
Artigo em Inglês | MEDLINE | ID: mdl-34767704

RESUMO

Successful bronchoscopic bronchopleural fistula closure requires both accurate localization of the fistula and device implantation; placing a silicone plug requires experience and skill because of the limited endobronchial working space. We report a novel bronchoscopic silicone plug placement technique for a bronchopleural fistula that developed after a left upper lobectomy following induction chemoradiation therapy, which was then successfully treated by omentopexy.


Assuntos
Fístula Brônquica , Doenças Pleurais , Fístula Brônquica/cirurgia , Broncoscopia , Cateterismo , Humanos , Doenças Pleurais/cirurgia , Silicones
19.
J Coll Physicians Surg Pak ; 31(12): 1459-1467, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34794288

RESUMO

The effects of bronchoscopy and chest CT on early evaluation of patients with hemoptysis are still controversial. PubMed, EMBASE, and the Cochrane Library databases were systematically searched. Odds ratio (OR) was applied to assess the utility of bronchoscopy for hemoptysis etiology and site in comparison with CT in the various clinical processes. A total of 23 studies were included (N=4635). The results showed that bronchoscopy implied a lower overall diagnostic accuracy, especially in identifying the etiology of hemoptysis, compared with CT (OR= 0.34, 95% CI: [0.23, 0.51], OR=0.21, 95% CI: [0.14, 0.31], respectively). When the results of radiograph were normal, the effectiveness of bronchoscopy was significantly weaker than that of CT (OR=0.32, 95% CI: [0.22, 0.45]). In the cases of massive hemoptysis, bronchoscopy and CT had no statistical significance for identifying bleeding (OR=0.27, 95% CI: [0.02, 3.18]). The study suggested that bronchoscopy did not show superior diagnostic accuracy than CT for patients with hemoptysis at the first visit. Key Words: Hemoptysis, Bronchoscopy, CT, Meta-analysis.


Assuntos
Broncoscopia , Hemoptise , Bases de Dados Factuais , Hemoptise/diagnóstico por imagem , Hemoptise/etiologia , Humanos , Razão de Chances , Tomografia Computadorizada por Raios X
20.
Kyobu Geka ; 74(12): 1043-1046, 2021 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-34795151

RESUMO

We experienced a case of a foreign body in the lung with granuloma by aspiration of watermelon seeds. A 72-year-old woman who had been diagnosed as having lung foreign body was admitted to our hospital for the treatment of the pulmonary shadow caused by the granuloma. A foreign body could not be identified by bronchoscopy, and the thoracoscopic partial resection of right S4 was performed. The postoperative course was uneventful, and the patient was discharged from our hospital on the second day after the operation.


Assuntos
Citrullus , Corpos Estranhos , Neoplasias Pulmonares , Idoso , Broncoscopia , Humanos , Pulmão
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