• Journal of Chest Surgery
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• v.34 no.10
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• pp.800-804
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• 2001

The intractable pneumothorax with continuous air leakage, emphysematous lung and high operative risk treated by selective bronchial occlusion has been seldomly reported abroad. The bronchus responsible for air leakage was occluded with such materials as fibrin glue, gelatin sponge and oxidized regenerated cellulose(surgicel). We performed selective bronchial occlusion by flexible fiberoptic bronchoscopy with gelfoam in two cases. There was no complication after the procedure; therefore, we report the treatment for intractable pneumo- thorax by bronchoscopy with gelfoam packing.

• Korean Journal of Head & Neck Oncology
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• v.24 no.1
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• pp.83-87
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• 2008

Hamartoma is one of the most common benign lung tumors. Most of them are located in the lung parenchyme, but very rarely it can originate endobronchially. Endobronchial hamartoma may cause irreversible lung damage due to the bronchial obstruction if it is not diagnosed and treated properly. The most frequent clinical features are hemoptysis and obstructive pneumonia. Transbronchial endoscopic surgery is a good therapeutic choice and is recommended first for patients who have resectable small endobronchial hamartoma. Here, we report a case of endobronchial hamartoma treated with rigid bronchoscopy and various microforceps with a review of the literature.

• Tuberculosis and Respiratory Diseases
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• v.45 no.2
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• pp.397-403
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• 1998

Background: Little information is available concerning the value of bronchoscopy in patients with a lymphocytic exudative pleural effusion in which percutaneous pleural biopsy have been regarded as cornerstone in investigating the etiology. Recently, a few reports suggest that bronchoscopy may be more effective diagnostic method in patients with unexplained pleural effusion accompanied by hemoptysis or other roentgenographic abnormalities, such as mass, infiltrate, atelectasis. Method: Mter initial examinations of sputum and pleural fluid through thoracentesis in 112 patients(male 75 cases, female 37 cases, mean age 53.2 years) who were admitted for evaluation of the cause of pleural effusion, we performed bronchoscopy and closed pleural biology in most patients with undiagnosed lymphocytic exudate and compared the diagnostic yield of both invasive methods according to hemoptysis or other roentgenographic abnormalities, and investigated the sole diagnostic contribution of bronchoscopy. Results: Tuberculosis(57 cases, 51%) was the most common cause of pleural effusion. Percutaneous pleural biopsy showed more diagnostic yield than bronchoscopy regardless of presence or absence of other clinical or radiologic abnormalities. In 25 cases with unknown etiology after pleural biopsy, additional diagnostic yield by bronchoscopy was 36 % (4/11) in patients with associated features and only 7 % (1/14) with lone effusion, and, as the sole mean for diagnsosis in all patients with pleural effusion, was only 4.5%(5/12). Conclusion : In a region of high prevalence of tuberculosis as a cause of pleural effusion, percutaneous pleural biospy is more effective method when invasive method is required for confirmative diagnosis of unexplained lymphocytic exudative pleural effusion, and bronchoscopy is unlikely to aid in the diagnosis of lone pleural effusion.

• Tuberculosis and Respiratory Diseases
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• v.80 no.3
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• pp.284-290
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• 2017

Background: We aimed to analyze the factors predicting the diagnostic performance of flexible bronchoscopy without guidance in peripheral lung lesions that are endoscopically invisible. Methods: This was a retrospective study conducted in St. Paul's Hospital, The Catholic University of Korea, between January 2007 and March 2013. We included all patients who received bronchoscopy during this period. The analyzed variables were age, sex, the etiology of the lesion, lesion size, distance from the pleura, and presence of the bronchus sign. We used multiple logistic regression analysis to identify the significant independent factors associated with diagnostic yield. Results: We included 151 patients in this study. The overall diagnostic yield was 58.3%. The sensitivity was 43.2% for malignant disease and 78.1% for benign disease. The benign lung lesions (p<0.001), lesion size (p=0.015), presence of the exposed type of bronchus sign (p<0.001), and presence of cavitary lung lesions (p=0.005) were factors influencing the yield of flexible bronchoscopy by univariate analysis. In a multivariate logistic regression analysis, the exposed type of bronchus sign and benign lung lesions were independent predicting factors (odds ratio [OR]: 27.95; 95% confidence interval [CI], 7.56-103.32; p<0.001 and OR, 4.91; 95% CI, 1.76-13.72; p=0.002). Conclusion: The presence of the exposed type of bronchus sign and benign lung lesions are determining factors of the diagnostic yield in flexible bronchoscopy in evaluating peripheral lesions that are not endoscopically visible.

• Tuberculosis and Respiratory Diseases
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• v.41 no.1
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• pp.20-25
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• 1994

Background: Hemoptysis is a common clinical symptom, responsible for 11% of admission to the hospital chest service. Correct diagnosis, accurate localization of the bleeding source and proper management are imperative to reduce the risk of massive hemoptysis. We performed the study to define the optimal time of fiberoptic bronchoscopy in 63 patients with hemoptysis admitted to Kyung Hee University Hospital between Aug 1989 and Aug 1992. Methods: Retrospective analysis of medical records concerning the cause, amount, duration of hemoptysis and the timing of fiberoptic bronchoscopy in 63(M:F=36:27) patients. Results: 1) The main causes of hemoptysis were pulmonary tuberculosis(52.4%) bronchiectasis(27.0%) and lung cancer(11.1%). 2) The bleeding sites were localized in 26 patients(41.3%). 3) The rates of localization of bleeding site were not related to the amount and duration of hemoptysis. 4) The rates of localization of bleeding site were 61.8%(21/34) during hemoptysis, 18.2%(22) within 24hr after resolution of hemoptysis, 14.3%(1/7) thereafter. Conclusion : Early bronchoscopy, especially during hemoptysis may show higher rates of successful localization than delayed bronchoscopy.

• Tuberculosis and Respiratory Diseases
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• v.55 no.6
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• pp.551-559
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• 2003

Background : Emergency management in hemoptysis is bronchial artery angiography and embolization. This study was designed to investigate the accuracy of localization of bleeding site by simple roentgenogram, computed tomography(CT) and bronchoscopy prior to embolization and to evaluate the outcome of embolotherapy. Method : We retrospectively evaluated 50 patients performed bronchial artery embolization(BAE), admitted to tertiary university hospital due to hemoptysis. Results : The most common causes were pulmonary tuberculosis, old tuberculous related parenchymal damage, aspergilloma, and bronchiectasis. The success rate of BAE within one month was 90%; within 3 months was 88%; during follow up period of mean 11.6 months was 76%. The concordant rate of simple roentgenogram with angiographic outcome in terms of bleeding site is 70%; in chest CT 80%; in bronchoscopy 81%; in combined information of simple roentgenogram and CT 83%; in combined information of simple roentgenogram and bronchoscopy 78%. Conclusion : The diagnostic accuracy for the bleeding site was similar between chest CT and bronchoscopy, showing high diagnostic yield. The success rate of BAE was comparative to prior studies. Further study will be needed in a large scale in near future.

• Tuberculosis and Respiratory Diseases
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• v.83 no.4
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• pp.276-282
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• 2020

Background: Flexible bronchoscopy is one of the essential procedures for the diagnosis and treatment of pulmonary diseases. The purpose of this study was to identify the risk factors associated with the occurrence of hypoxia in adults undergoing flexible bronchoscopy under sedation. Methods: We retrospectively analyzed 2,520 patients who underwent flexible bronchoscopy under sedation at our tertiary care university hospital in South Korea January 1, 2013-December 31, 2014. Hypoxia was defined as more than 5%-point reduction in the baseline percutaneous oxygen saturation (SpO₂) or SpO₂ <90% for >1 minute during the procedure. Results: The mean age was 64.7±13.5, and 565 patients developed hypoxia during the procedure. The mean sedation duration and midazolam dose for sedation were 31.1 minutes and 3.9 mg, respectively. The bivariate analysis showed that older age, a low forced expiratory volume in one second (FEV₁), use of endobronchial ultrasound, the duration of sedation, and the midazolam dose were associated with the occurrence of hypoxia during the procedure, while the multivariate analysis found that age >60 (odds ratio [OR], 1.32), a low FEV₁ (OR, 0.99), and a longer duration of sedation (>40 minutes; OR, 1.33) were significant risk factors. Conclusion: The findings suggest that patients older than age 60 and those with a low FEV₁ tend to develop hypoxia during the bronchoscopy under sedation. Also, longer duration of sedation (>40 minutes) was a significant risk factor for hypoxia.

• Tuberculosis and Respiratory Diseases
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• v.72 no.3
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• pp.261-274
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• 2012

For decades, the standard technique for tracheostomy was the open, surgical technique. However, during the past 20 years, the use of percutaneous dilatational tracheostomy has been increased and shown to be a feasible and safe procedure in critically ill patients. The purpose of this report is to review the percutaneous dilatational tracheostomy technique, describe the role of bronchoscopy as guidance for the procedure, and identify the available evidences comparing percutaneous dilatational tracheostomy to surgical tracheostomy.

• Tuberculosis and Respiratory Diseases
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• v.68 no.1
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• pp.16-21
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• 2010

Background: Lung cancer is usually diagnosed at an advanced stage, resulting in a poor prognosis. The detection of these lesions at an earlier stage would be a clear benefit to patients. However, it is extremely difficult to detect carcinomatous lesions in the bronchial mucosal sites during a routine bronchoscopy. Methods: This study employed a novel optical technique, known as narrowband imaging (NBI), which allows noninvasive visualization of the microvascular structure of an organ's surface using reflected light. Results: Narrow band imaging was performed on 10 patients who were radiologically suspicious or had a high risk of lung cancer. The median age of the patients was 57.5 years (range, 44~81 years), and 80% of the patients were male. All lesions showed a microvascular proliferation pattern (dotted, tortuous and abruptly ending vessel) on the magnified NBI. Two lesions were confirmed histologically to be adenocarcinoma and the remaining lesions were squamous cell carcinomas. Two lesions were confirmed histologically to be a carcinoma in situ. Conclusion: NBI is a promising and potentially powerful tool for identifying carcinomas at an earlier stage or a central lesion during a routine bronchoscopy examination.

• Journal of Chest Surgery
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• v.11 no.2
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• pp.129-134
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• 1978

Two hundred and seventeen patients underwent diagnostic rigid bronchoscopy or bionchofiberscopy to evaluate the cytologic diagnosis in the lung cancer patient at the department of chest surgery of Yon-Sei university, college of the medicine from 1971 to 1977 year. One hundred and twenty cases of these patients were taken rigid bronchoscopy and ninety four cases of these patient were taken bronchofiberscopy. Cytologic examination of the sputum was done in 214 cases and sputum cytology was positive in 50 cases [23.4%]. Rigid bronchoscopy was made in 120 cases and this bronchoscopic cytology including bronchial washing and bronchial biopsy was positive in 34 cases [28.5%]. Bronchofiberscopy was performed in 94 cases and was positive in 45 cases [47.5%]. Histopathologically, 41 cases [43.6%] were epidermoid cell carcinoma, 8 cases [8.5%]of undifferentiated cell type, 12 cases [12.8%]of adenocarcinoma, 8 cases [8.5%]of alveolar cell type, and the 25 cases were undetermined. Cytologic examination of the sputum lacks the accuracy of the bronchoscopies in terms of both localization and accurate histologic indentification of the type of neoplasm. Rigid bronchoscope has the advantage of permitting identification of a tumor in a central location and of providing a sufficient amount of biopsy material for accurate diagnosis of carcinoma. However, it has the disadvantage of limiting examination to the larger, more central portions of the tracheobronchial tree. Bronchofiberscope had the advantage of examine upper lobe as well as other portions of the tracheobronchial tree which could not be visualized with the rigid bronchoscopy. A positive diagnosis in bronchofiberscopy was obtained in the highest rate, 47. 8% [45 cases]. A1 last, if a bronchogenic carcinoma is suspected on the basis of either symptoms of an abnormality on the chest film the diagnostic work-up-sputum cytology, bronchial washing, bronchoscopic biopsy, scalene node biopsy, thoracentesis and mediastinoscopy explothoracotomy etc-should precede in an attempt not only to obtain the higher positive diagnosis but also to obtain a tissue diagnosis and to evaluate the stage of the disease and to ascertain the appropriate mode of therapy.