• Journal of Chest Surgery
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• v.13 no.3
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• pp.206-211
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• 1980

One hundred and thirteen patients underwent diagnostic fiberoptic bronchoscopy to exclude the presence of the lung cancer at the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital from January 1979, to July 1980. Sixty five cases of these patients were studied for passible lung cancer by bronchoscopic examination. Patients varied in age from 24 to 75 years, with the highest concentration lying in the sixth decade (49%). male was predominated with sex ratio of 6.3 : 1. Forth three (75.4%) of 57 cases impressed as definitive, and 8(14.5%) of 55 cases impressed as negatibe lung cancer were subsequently proved to have had lung cancer. Positive bronchoscopic biopsy was found in 10 of 14 lung cancers which were situated in the left main bronchus and in 11 of 13 neoplasms involving the right upper lobe bronchus. epidermoid cell carcinomas were most frequent(82.4%). Bronchial biopsy detected 34(79%) of 43 hilar cancers and 1.3(59%) 22 periphera neoplasms, in those patients who had fiberoptic bronchoscopic examinations. In the present series of 65 cases, the lesion was so far advanced when first seen that it was considered inoperable in 31 (47.7%) and operable 34(52.3%), 19(55.9%) of these refusing surgery. fifteen were explored of whom 12(80%) were resectable.

• Tuberculosis and Respiratory Diseases
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• v.82 no.4
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• pp.335-340
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• 2019

Background: Snoring is the cardinal symptom of obstructive sleep apnea (OSA). Snoring and upper airway obstruction associated with major oxygen desaturation may occur in populations undergoing flexible bronchoscopy. Methods: To evaluate the prevalence of patients at a high risk of having OSA among patients undergoing bronchoscopy with sedation and to investigate whether snoring during the procedure predicts patients who are at risk of OSA, we prospectively enrolled 517 consecutive patients who underwent the procedure with moderate sedation. Patients exhibiting audible snoring for any duration during the procedure were considered snorers. The STOP-Bang (Snoring, Tiredness, Observed apnea, high blood Pressure-Body mass index, Age, Neck circumference and Gender) questionnaire was used to identify patients at high (score ${\geq}3$ out of 8) or low risk (score <3) of OSA. Results: Of the 517 patients, 165 (31.9%) snored during bronchoscopy under sedation. The prevalence of a STOP-Bang score ${\geq}3$ was 61.9% (320/517), whereas 200 of the 352 nonsnorers (56.8%) and 120 of the 165 snorers (72.7%) had a STOP-Bang score ${\geq}3$ (p=0.001). In multivariable analysis, snoring during bronchoscopy was significantly associated with a STOP-Bang score ${\geq}3$ after adjustment for the presence of diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease, and stroke (adjusted odds ratio, 1.91; 95% confidence interval, 1.26-2.89; p=0.002). Conclusion: Two-thirds of patients undergoing bronchoscopy with moderate sedation were at risk of OSA based on the screening questionnaire. Snoring during bronchoscopy was highly predictive of patients at high risk of OSA.

• Tuberculosis and Respiratory Diseases
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• v.70 no.6
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• pp.516-520
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• 2011

Bronchial carcinoid tumor accounts for less than 5% of all primary lung tumors in adults. Although surgical resection is the treatment of choice, here we report a case of bronchial carcinoid tumor treated with flexible bronchoscopic resection. A 19-year-old-man presented with a history of wheezing with dyspnea for six months. A simple chest x-ray showed no abnormal findings, but a pulmonary function test showed a moderate obstructive lung disease pattern without a bronchodilator response. A computed tomogram of the thorax revealed an enhanced $15{\times}12$ mm nodule in the left main bronchus. Bronchoscopic examination showed a polypoid mass with a stalk in the left main bronchus, which almost completely occluded the left main bronchus. Histopathology of the resected specimen revealed a bronchial carcinoid tumor. We treated the carcinoid tumor with a flexible bronchoscopic resection. During the follow up period of 6 months, the previous tumor didn't relapse. Initial bronchoscopic resection should be considered when bronchial carcinoid tumor can be approached by bronchoscopy.

• 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.

• Tuberculosis and Respiratory Diseases
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• v.49 no.3
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• pp.353-364
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• 2000

Background : Bronchoscopy is a useful diagnostic tool, for accurate localization of the bleeding site and the management of hemoptysis. However, there is some controversy about the optimal timing of bronchoscopy. Method : To determine the optimal timing of bronchoscopy in hemoptysis, we reviewed the medical records of 118 patients and analyzed the following relationships amongst simple chest PA findings, namely, the duration and amount of hemoptysis, and the timing of bronchoscopy retrospectively. Results : The major causes of hemoptysis were active tuberculosis(28.8%), inactive tuberculosis(10.2%), bronchiectasis(17.0%), lung cancer(7.6%), and aspergilloma(7.6%). Localization of the bleeding focus by bronchoscopy was possible in 87.5% (21/24 cases) during active bleeding, and it was possible in 40.4% after bleeding had stopped(p<0.05). The localization rate of bleeding focus was 59.8% when the chest PA showed certain abnormalities, but it decreased to 27.8% when the chest PA finding was normal(p<0.05). When chest PA showed diffuse abnormalities or its finding was normal, the localization rate of bleeding focus significantly increased if bronchoscopy was performed during bleeding or within 48 hours of the cessation of active bleeding. The localization rate was higher as the amount of hemoptysis became larger(p<0.05). The localization rate of early bronchoscopy(during bleeding or within 48 hours of the cessation of active bleeding) was significantly higher when the duration of hemoptysis was less than 1 week, but there was no advantage if the duration was 1 week or longer. Early bronchoscopy was also necessary to localize the bleeding focus for surgical resection in 4 patients, and the bronchoscopy itself was therapeutic in 1 patient whose bleeding was successfully managed with thrombin-application via bronchoscope. Conclusion : It is concluded that flexible bronchoscopy is useful at not only localizing the bleeding focus but also in preparing a therapeutic plan, and early bronchoscopy is more favorable in hemoptysis.

• Korean Journal of Bronchoesophagology
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• v.15 no.2
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• pp.81-86
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• 2009

A 57 year old human immune virus(HIV)-positive male presented with a progressive dyspnea for 6 months. Chest CT showed multiple polypoid masses arising from upper tracheal wall. Bronchoscopic examination revealed that multiple large cauliflower-like polypoid tumors was obstructing tracheal lumen. They were diagnosed as multiple squamous papillomas and were removed by Nd:YAG laser photocoagulation and rigid bronchoscopic treatment. The tumors were histologically diagnosed as squamous papilloma infected with human papilloma virus(HPV) type 6 and 11 in in-situ hybridization. Rigid bronchoscopy might be safer and more efficient than flexible bronchoscopy for the treatment of multiple tracheal papillomatosis obstructing tracheal lumen because of easy establishment of airway patency and direct use of rigid bronchoscope itself for tumor resection.

• Tuberculosis and Respiratory Diseases
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• v.77 no.4
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• pp.193-196
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• 2014

Acute airway obstruction after hemoptysis occurs due to the presence of blood clots. These conditions may result in lifethreatening ventilation impairment. We report a case of obstruction of the large airway by endobronchial blood clots which were removed using bronchoscopic cryotherapy at the bedside of intensive care unit. A 66-year-old female with endometrial cancer who had undergone chemotherapy, was admitted to the intensive care unit due to neutropenic fever. During mechanical ventilation, the minute ventilation dropped to inadequately low levels and chest radiography showed complete opacification of the left hemithorax. Flexible bronchoscopy revealed large blood clots obstructing the proximal left main bronchus. After unsuccessful attempts to remove the clots with bronchial lavage and forceps extraction, blood clots were removed using bronchoscopic cryotherapy. This report shows that cryotherapy via flexible bronchoscopy at the bedside in the intensive of intensive care unit is a simple and effective alternative for the removal of endobronchial blood clots.

• Tuberculosis and Respiratory Diseases
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• v.43 no.6
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• pp.1028-1034
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• 1996

The leiomyoma of the bronchus is a very rare benign tumor in the lower respiratory tract. Though classical treatment of the bronchial leiomyoma is surgical resection, bronchoscopic tumor resection has been recently applied to selected cases. We experienced two cases of bronchial leiomyomas which were successfully resected under flexible bronchoscopy using Nd-YAG laser and bronchial snare. We speculated that bronchoscopic resection of the bronchial leiomyoma would be an effective and safe way of treatment, and more technical developments should follow.

• Journal of Trauma and Injury
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• v.36 no.3
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• pp.206-209
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• 2023

Purpose: Since its implementation, flexible fiberoptic bronchoscopy (FBS) has played an important role in the diagnosis and treatment of tracheobronchial tree and pulmonary disease. Although FBS is often performed by endoscopists, it has also been performed by surgeons, albeit rarely. This study investigated FBS from the surgeon's perspective. Methods: This retrospective study included patients who underwent FBS performed by a single thoracic surgeon between March 2017 and December 2021. Accordingly, the epidemiology, purpose, results, and complications of FBS were analyzed. Results: A total of 47 patients received FBS, whereas 13 patients underwent repeat FBS. Their mean age was 60.7 years. The main organs injured involved the chest (n=22), brain (n=9), abdominal organ (n=7), cervical spine (n=4), extremities (n=4), and face (n=1). The average Injury Severity Score was 22.5. Indications for FBS included atelectasis or haziness on chest x-ray (n=34), pneumonia (n=17), difficult ventilator management (n=7), percutaneous dilatory tracheostomy (n=3), blood aspiration (n=2), foreign body removal (n=2), and intubation due to a difficult airway (n=1). The findings of FBS were mucous plugs (n=36), blood and blood clots (n=16), percutaneous dilatory tracheostomy (n=3), foreign bodies (n=2), granulation tissue at the tracheostomy site (n=2), tracheostomy tube malposition (n=1), bronchus spasm (n=1), difficult airway intubation (n=1), and negative findings (n=5). None of the patients developed complications. Conclusions: FBS is an important modality in the trauma field that allows for the possibility of diagnosis and therapy. With sufficient practice, surgeons may safely perform FBS at the bedside with relative ease.

• Korean Journal of Bronchoesophagology
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• v.17 no.1
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• pp.9-13
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• 2011

Endobronchial ultrasound (EBUS), which enables visualization of lesions beyond the bronchus, broadens the fields of bronchoscopy. Two types of ultrasound, radial and linear, are used for bronchoscopy. Radial EBUS is performed by inserting an ultrasound mini-probe through the working channel of a flexible bronchoscope. Evaluation of the depth of invasion of early endobronchial lung cancers using radial EBUS is useful in deciding endobronchial treatment. A central tumor limited to within the cartilaginous layer is a good indication for endobronchial photodynamic therapy. EBUS-guide sheath (GS) technique is a sampling method assisted by localization of peripheral lesions using EBUS. The diagnostic yield of EBUS-GS method is higher than that of conventional transbronchial biopsy. High diagnostic values of EBSU-GS method are reported even in small (${\leq}2cm$) peripheral tumors. Linear EBUS is used for endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA). EBUS-TBNA has high diagnostic yields in mediastinal staging of lung cancer even in patients having radiologically early stage lung cancers with normal CT or PET findings in the mediastinum. EBUS is a valuable method in evaluating early endobronchial tumors and peripheral small lung cancers and as well as in mediastinal staging.