Alraiyes Abdul Hamid, Machuzak Michael S
Division of Interventional Pulmonology, Department of Medicine, Roswell Park Cancer Institute, Buffalo, New York.
Department of Pulmonary Allergy and Critical Care Medicine, Respiratory Institute, Cleveland Clinic Foundation, Cleveland, Ohio.
Semin Respir Crit Care Med. 2014 Dec;35(6):671-80. doi: 10.1055/s-0034-1395500. Epub 2014 Dec 2.
The purpose of this article is to provide an introduction to rigid bronchoscopy (RB). We will briefly discuss its history, evolution, and resurgence while we highlight its versatility and usefulness for today's interventional pulmonologist and thoracic surgeon. Despite being one of the earliest pulmonary procedures described, RB is still an important technique. Advances in thoracic medicine have made this skill critical for a fully functional interventional pulmonary program. If the interventional pulmonologist of this century is to be successful, he or she should be facile in this technique. Despite the availability of RB for decades, the invention of flexible bronchoscopy in 1966 led to a significant downturn in its usage. The growth of the interventional pulmonology field brought RB back into the spot light. Apart from the historic role of RB in treatment of central airway lesions and mechanical debulking of endobronchial lesions, RB is the key instrument that can adapt modern therapeutic tools such as laser, argon plasma coagulation, electrocautery, cryotherapy, and stent deployment. Performing RB requires proper preprocedure preparation, exceptional understanding of upper airway anatomy, specific hand-eye coordination, and open communication between the bronchoscopist and the anesthesiologist. These skills can be primarily learned and maintained with repetition. This article will review information relevant to this technique and lay a foundation to be built upon for years to come.
本文旨在介绍硬质支气管镜检查(RB)。我们将简要讨论其历史、发展历程及再度兴起,同时突出其对当今介入肺科医生和胸外科医生的多功能性及实用性。尽管RB是最早被描述的肺部手术之一,但它仍是一项重要技术。胸科医学的进步使这项技能对于一个具备完整功能的介入肺科项目至关重要。如果本世纪的介入肺科医生想要取得成功,就应该熟练掌握这项技术。尽管RB已存在数十年,但1966年可弯曲支气管镜的发明导致其使用量大幅下降。介入肺科领域的发展使RB重新成为焦点。除了RB在治疗中央气道病变和对支气管内病变进行机械减容方面的历史作用外,RB还是适配激光、氩等离子体凝固、电灼、冷冻疗法和支架置入等现代治疗工具的关键器械。进行RB需要进行适当的术前准备,对上气道解剖结构有透彻的了解,具备特定的手眼协调能力,以及支气管镜检查医生和麻醉医生之间的开放沟通。这些技能主要可以通过反复练习来学习和保持。本文将回顾与这项技术相关的信息,并为未来数年的进一步发展奠定基础。