Tuberc Respir Dis.  2012 Jun;72(6):486-492.

Clinical Experience of Rigid Bronchoscopy in Single Center

• Kim HJ
• Kim SW
• Lee HY
• Kang HH
• Kang JY
• Kim JS
• Kim MS
• Kim SS
• Kim JW
• Yun HG
• Kim CH
• Kim KH
• Moon HS
• Cho KJ
• Moon SH
• Lee SH

Abstract

BACKGROUND
The aim of this study was to analyze clinical situations requiring rigid bronchoscopy and evaluate usefulness of rigid bronchoscopic intervention in benign or malignant airway disorders.
METHODS
We retrospectively reviewed 29 patients who underwent rigid bronchoscopy from November 2007 to February 2011 at St. Paul's Hospital, The Catholic University of Korea School of Medicine.
RESULTS
Of the 29 patients, the most frequent underlying etiology was benign stenosis of trachea (n=20). Of those 20 patients, 16 had post-intubation tracheal stenosis (PITS), 2 had tracheal stenosis due to inhalation burn (IBTS) and other 2 had obstructive fibrinous tracheal pseudomembrane (OFTP). Other etiologies were airway malignancy (n=6), endobronchial stenosis due to tuberculosis (n=2), and foreign body (n=1). For treatment, silicone stent insertion was done in 16 cases of PITS and IBTS and mechanical removal was performed in 2 cases of OFTP. In 6 cases of malignant airway obstruction mechanical debulking was performed and silicone stents were inserted additionally in 2 cases. Balloon dilatation and electrocautery were used in 2 cases of endobronchial stenosis due to tuberculosis. In all cases of stent, airway obstructive symptom improved immediately. Granulation tissue formation was the most common complication.
CONCLUSION
Tracheal stenosis was most common indication and silicone stenting was most common procedure of rigid bronchoscopy in our center. Rigid bronchoscopic procedures, at least tracheal silicone stenting, should be included in pulmonary medicine fellowship programs because it is a very effective and indispensable method to relieve critical airway obstruction which needs training to learn.

Keyword

Bronchoscopy; Pulmonary Medicine; Tracheal Stenosis; Airway Obstruction

MeSH Terms

Airway Obstruction
Bronchoscopy
Burns, Inhalation
Constriction, Pathologic
Dilatation
Electrocoagulation
Fellowships and Scholarships
Fibrin
Foreign Bodies
Granulation Tissue
Humans
Korea
Pulmonary Medicine
Retrospective Studies
Silicones
Stents
Trachea
Tracheal Stenosis
Tuberculosis
Fibrin
Silicones

Figure

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  Figure 1 Rigid bronchoscopic intervention for benign tracheal stenosis. *Insertion failure of rigid bronchoscopy due to anatomical problem (inability to withstand hyperextension of neck). OFTP: obstructive fibrinous tracheal pseudomembrane.

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  Figure 2 Representative bronchoscopic findings in a patient with post-intubation tracheal stenosis. (A) Baseline bronchoscopy showed marked tracheal stenosis. (B) After silicone stent insertion, bronchoscopy showed good patency in trachea.

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  Figure 3 Rigid bronchoscopic intervention for other etiologies.

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