Bronchoscopy lung: what is it and why do it?
Widespread diseases of the respiratory system leads to the development of various types of diagnostic and therapeutic procedures. One of such methods is a bronchoscopy of the lungs. Fiber-optic bronchoscopy (FBS) is a method of endoscopic examination of the trachea and bronchi with the ability to detect diseases before the development of serious symptoms. The main indications for bronchoscopy were chronic bronchial disease, suspected tumor, tuberculosis, recurrent pneumonia, etc. In this case the attending physician has the opportunity during endoscopy to biopsy for further morphological diagnosis of the disease. FBS bronchoscopy is well tolerated by virtually all patients and has a low risk of negative effects, however, the purpose of this method of examination should always be based on existing indications and contraindications for execution.
What is a bronchoscopy? It is a method of studying the state of the bronchi and trachea using endoscopic equipment that allows to diagnose diseases in the early stages of their development. Bronchoscopy lung is carried out using a bronchoscope – a flexible probe of small diameter with a camera and a light source at the end. The resulting image is displayed on a computer or any other monitor that allows the doctor to see the condition of the bronchial mucosa in real time. It is also possible to record the results for later analysis or comparison with new data in the treatment.
The correct technique of bronchoscopy determines the effectiveness of the procedure and its safety. A similar study should always be in a special Cabinet with endoscopic equipment, in which respect a high level of sterility. This technique is performed only by a physician, having passed additional training and knowing the technical details of the survey.
Before the procedure the patient is injected Atropine or Salbutamol. Similar drugs to expand the bronchi and to ensure easy advancement of the bronchoscope, especially if you use modern tools introduced through the nose and having a small diameter. The patient at this time sitting or lying on the back, which provides the optimum location of organs of neck and pectoral cavity. In no case do not bend the neck or pull the head, as this can lead to dangerous consequences.
After the patient took the best position, the bronchoscope is gently inserted through the nose or through the mouth, pushing it deep into the respiratory tract under continuous visual control. The endoscope should easily pass through the trachea into the bronchial tree. Patients with this may cause mild discomfort in the chest associated with irritation of the mucous membrane.
Doctor closely monitor the progress of the procedure and evaluates the condition of the larynx, vocal cords, trachea and bronchial tubes, which gradually become more and more narrow, going deep into the lungs. The bronchoscope provides a high quality image, which is transmitted to the monitor that allows you to monitor the procedure in real time. If the doctor sees suspicious areas of the mucosa, biopsy or flush, which allows to evaluate cells and tissue due to morphological methods of research.
After bioscopia finished, the endoscope is carefully removed. Within a few hours after the procedure, the patient may be left with a feeling of discomfort, numbness of throat or even a slight cough. Typically, the procedure takes the patient from 30 minutes to 2 hours, depending on the objectives of the study. Usually sanation bronchoscopy lasts a bit longer diagnostic. Its duration is associated with a longer preparatory phase and the need for minihydroelectric procedures. After the procedure the patient should remain in hospital until the cessation of the effects of General anesthesia and confirmation of absence of adverse effects. Does it hurt to hold such survey? Adequate pain relief helps to prevent the appearance of pain syndrome.
A study done with various methods of pain relief, most important of which is General and local anesthesia:
- Under General anesthesia, bronchoscopy and subsequent biopsy is performed in children and individuals with mental illness. Why is it necessary? This allows you to protect them from possible damage to the respiratory tract.
- The main method of anesthesia in the study of the bronchi in adults, local anesthesia with the help of dilute solution of Lidocaine, Procaine or similar. Such anesthesia is necessary to ensure the insensibility of the mucous membrane of the pharynx and larynx, which prevents vomiting and spasm of the vocal cords. Its implementation should always be carried out before the examination.
Anesthesia for bronchoscopy is selected only by the attending physician based on the condition of the patient’s allergic history and age. However, it is important to remember that anesthesia is necessary, be it local anesthesia during the study or bronchoscopy under General anesthesia.
A version of the
There are several types of this research method, among which decided to allocate the actual bronchoscopy and its «virtual» variety, associated with the use of an MRI or CT scan.
- Fiber-optic bronchoscopy is performed through the use of a flexible endoscope with fiber-optic optics. This is the most common in hospitals method of detecting pulmonary and bronchial diseases.
- The rigid bronchoscope (rigid bronchoscopy) is rather limited and is often part of the story, as it significantly loses its analogues.
- Virtual bronchoscopy is performed by using computed tomography and helps to detect diseases of the bronchi non-invasive technique.
The answer to the question about the choice of a particular method, gives the attending physician based on clinical information about the patient identified diseases and order treatments.
Bronchoscopy is performed with continuous visual monitoring its progress, which shows the correctness of its implementation and increase the level of safety for humans.
Indications and contraindications to the examination
Diagnostic bronchoscopy and its therapeutic equivalent for sanation is carried out with the following indication for the operation:
- Suspicions to common pathological processes in the lung tissue and bronchi.
- Benign or malignant tumors in the walls of the bronchi.
- Clinical evidence of long-existing the patient’s shortness of breath or hemoptysis.
- Chronic inflammation or abscesses in the lungs.
- The necessity of sowing microflora bronchi to identify the microorganisms and their sensitivity to antibiotic therapy.
- Suspicion of the bronchi or anomalies in their structure.
- Bronchoscopy with bronchial asthma can help determine the cause.
Indications for bronchoscopy is very important, however, the patient may be contraindications to its conduct, restrict the use of this diagnostic procedure:
- Narrowing of the lumen of the larynx or trachea 2 or 3 degrees, which does not allow to introduce the bronchoscope.
- End-stage respiratory failure.
- An attack of bronchial asthma or status asthmaticus.
- Decompensated diseases of the cardiovascular or respiratory system.
- Pronounced obstructive symptoms (severe shortness of breath, cyanosis of the skin, etc.).
- The acute phase of mental illness.
Contraindications to bronchoscopy not allow its holding in this patient, which requires from the attending physician a choice of similar methods. However, virtual bronchoscopy in these cases is a good solution and can often be used as an alternative method.
Preparation for the examination
Bronchoscopy in tuberculosis and any other diseases requires special preparation of the patient for the examination. It starts 1-2 days before treatments and includes clinical examination of the patient, conducting a General analysis of blood and urine, as well as panoramic radiographs of the chest. If the procedure is prescribed in patients with COPD (chronic obstructive pulmonary disease), additionally investigate the gas composition of blood. Virtual bronchoscopy does not require any additional preparation and can be conducted immediately upon admission of the patient.
Recommendations for training include the following:
- The patient should tell your doctor about all existing medical conditions and those seen in the past allergic reactions.
- If the patient takes certain medications that affect the brain (sedatives, antidepressants, etc.), they also need to tell the doctor.
- For 8-10 hours before the procedure, you must give up eating. What is it? This reduces the likelihood of ingress of stomach contents into the respiratory tract.
- If you experience discomfort after bronchoscopic examination is necessary to tell about the feelings to the attending physician.
Virtual bronchoscopy is a modern method of examination of respiratory system. This bronchoscopy is not quite normal, as no bronchoscope is not used. The procedure is based on a CT scan, but the doctor receives a specially recreated the image of the bronchi with the possibility of inspecting them from the inside. Virtual bronchoscopy diagnose various pathological processes, however, does not allow to identify them in the early stages, when only slightly affected mucous membrane.
This method of indirect study of the bronchi is not invasive, which is better suited to some patients. However virtual there is the possibility of direct inspection of the inner shell and the possibility of therapeutic intervention.
The holding of such procedures is always based on the existing algorithms to increase the efficiency of the survey.
The examination takes much less time, as applied to modern computer tomography, which allows to obtain three-dimensional image in a few minutes. But, there is an additional disadvantage – no possibility to take a biopsy and clarify the diagnosis.
Assign a standard or a virtual bronchoscopy on the basis of the conclusion of the attending physician, which identifies the indications and contraindications for a particular method. How much is a bronchoscopy? The average cost of conventional bronchoscopy 2-4 thousand rubles, and virtual – from 6 thousand.
Consequences of the procedure
Bronchoscopy for lung cancer and other diseases may lead to development of various complications, the most important of which are:
- Allergic reaction to used drugs or reflex spasm of the glottis when the mechanical irritation of the mucous membrane.
- The damage to the wall of the bronchus with development of intrabronchial bleeding or formation of a fistula.
- Adhesions inside the bronchi.
- Violation of bronchial drainage function with the development of aspiration pneumonia.
The emergence of these situations requires therapeutic measures aimed at preventing their progression.
Bronchoscopy of the lungs, what is it? This modern method of examination of bronchi that can diagnose different pathological processes of the wall and may provide answers about the causes of diseases. The existing varieties of methods allow you to do a survey appropriate for all patients with maximum efficiency and safety.