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具有1.7毫米工作通道的新型细支气管镜用于周围性肺病变。

Novel thin bronchoscope with a 1.7-mm working channel for peripheral pulmonary lesions.

作者信息

Oki M, Saka H, Kitagawa C, Tanaka S, Shimokata T, Mori K, Kajikawa S

机构信息

Dept of Respiratory Medicine, Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya 460-0001, Japan.

出版信息

Eur Respir J. 2008 Aug;32(2):465-71. doi: 10.1183/09031936.00169107. Epub 2008 Apr 16.

Abstract

In the present study, the authors evaluated the diagnostic utility of a novel thin bronchoscope with a 1.7-mm working channel for peripheral pulmonary lesions. A total of 118 patients were included in this prospective study. Bronchoscopic examination was performed using a 5.9-mm standard bronchoscope. If no visible endobronchial lesion was found, transbronchial biopsies were performed with 1.5-mm biopsy forceps under fluoroscopic guidance and the bronchus were washed with 10-20 mL of saline solution, using a prototype 3.5-mm thin bronchoscope with a 1.7-mm working channel. Endobronchial lesion was visualised with the standard bronchoscope in 16 patients, and the other 102 patients underwent biopsies with the thin bronchoscope. The mean bronchus levels reached with the standard bronchoscope and the thin bronchoscope were 2.3 and 4.3 generations, respectively. Endobronchial abnormality was revealed with the thin bronchoscope in a further 14 patients. Diagnostic material was obtained in 50 of 68 (74%) patients with malignant disease and 18 of 30 (60%) patients with benign disease. Four patients did not return to follow-up. The diagnostic yield was 57%, even in lesions <20 mm. There were no major complications. In conclusion, bronchoscopy using a 3.5-mm thin bronchoscope with a 1.7-mm working channel is useful and safe for the diagnosis of peripheral pulmonary lesions.

摘要

在本研究中,作者评估了一种具有1.7毫米工作通道的新型细支气管镜对外周肺部病变的诊断效用。这项前瞻性研究共纳入了118例患者。使用5.9毫米标准支气管镜进行支气管镜检查。如果未发现可见的支气管内病变,则在透视引导下用1.5毫米活检钳进行经支气管活检,并用10 - 20毫升盐溶液冲洗支气管,使用的是具有1.7毫米工作通道的3.5毫米原型细支气管镜。16例患者用标准支气管镜观察到支气管内病变,另外102例患者用细支气管镜进行活检。标准支气管镜和细支气管镜到达的平均支气管水平分别为2.3级和4.3级。细支气管镜在另外14例患者中发现了支气管内异常。68例恶性疾病患者中有50例(74%)以及30例良性疾病患者中有18例(60%)获得了诊断材料。4例患者未进行随访。即使在病变小于20毫米的情况下,诊断率仍为57%。未发生重大并发症。总之,使用具有1.7毫米工作通道的3.5毫米细支气管镜进行支气管镜检查对外周肺部病变的诊断是有用且安全的。

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