Bronchography Research Articles

Clinical application of three-dimensional computed tomography bronchography and angiography in thoracoscopic segmentectomy

Objective To explore the clinical value of three-dimensional computed tomography bronchography and angiography (3D-CTBA) in thoracoscopic dissection or combined segmentectomy. Methods The clinical data of 30 patients with isolated or multiple pulmonary nodules from September 2017 to August 2019 were retrospectively analyzed. All cases were treated with 3D-CTBA to locate the nodules accurately before operations, in order to explicit the courses of bronchi and vessels, and to observe the variations. The target bronchi, arteries and veins were resected accurately during the operations, and the intersegmental plane was determined by expansion-collapse method. Results 13 patients underwent segmentectomy and 17 patients underwent combined segmentectomy. The diameter of the nodule was (11.56±3.79)mm; the depth of the nodule (the shortest distance from the visceral pleura) was (13.88±3.96)mm; the operation time was (134.94±18.68)min, and the intraoperative bleeding volume was (94.38±37.94)ml. No cancer metastasis was found by rapid pathological examination of lymph nodes during operations. No conversion to thoracotomy. The indwelling time of thoracic tube was (3.69±1.30)days, and the hospitalization days after operations was (4.81±1.47)days. No serious complications or death during the perioperative period. Conclusions Preoperative 3D-CTBA has advantages in pulmonary segmentectomy, which is a safe and effective method for accurate segmentectomy. Key words: Imaging, three-dimensional; Bronchography; Thoracoscopy; Pneumonectomy

The application of 3D reconstruction technique in thoracoscopic posterior basal segmentectomy

Objective To explore the safety and effectiveness of 3D reconstruction in thoracoscopic posterior basal segmentectomy (S10). Methods Between March 2018 to September 2018, 14 patients underwent thoracoscopic anatomical resection of the posterior basal segment of the lung (S10). Results Of the 14 patients, including 5 males and 9 females, age (52.2±5.3)years, size (1.1±0.6)cm, 6 left S10 and 8 right S10. The number of pathological type of microinvasive adenocarcinoma, benign nodule, and metastatic carcinoma was 12, 1, and 1 cases. The average preoperative planning time was (44.9±5.7)min, and the average operation time was (134.8±26.3)min. The blood loss was (25.5±4.1)ml, with (8.1±2.7) lymphadenectomy, no positive metastasis. The coincidence rate of 3D reconstruction and intraoperative anastomosis in the tumor location, B10, A10, and V10 were 100%(14/14), 100%(14/14), 93%(13/14) and 71%(10/14). The median duration of chest tube insertion was (2.3±2.1)day. The incidence of postoperative complications was 21%(3/14), including 7%(1/14) of air leakage, 7%(1/14) of arrhythmia, 14%(2/14) of pulmonary infection, and 14%(2/14) of operation. All the cutting edge was >2 cm. There was no perioperative death, no conversion to thoracotomy or lobectomy. The mean follow-up time was (8.1±2.2)months. There were no recurrence, metastasis or death in the 14 patients. One patient had chronic cough and no hemoptysis. Conclusions Preoperative 3D reconstruction make the anatomic thoracoscopic posterior basal segmentectomy (S10) safer and more effective. Key words: Imaging, three-dimensional; Bronchography; Thoracoscopy; Pneumonectomy

Incidental Bronchography

Incidental Bronchography

The Reassessment of The Conventional Bronchography

The Reassessment of The Conventional Bronchography

Bronchiectasis with normal paranasal sinus roentgenogram

Bronchiectasis has come to be considered as a type of sinobronchial syndrome in Japan, but there exist some cases without chronic sinusitis. We studied the clinical features of 14 cases of bronchiectasis with definitely normal paranasal sinus roentgenogram, diagnosed during the past ten years. There were eleven middle-aged women and three men. Ten patients (71%) complained of hemoptysis, one (7%) of dry cough, one (7%) of productive cough, and the two (14%) had no complaint. In seven patients (50%) CT and bronchography showed localized cylindrical bronchiectasis in the right middle lobe and/or left upper lobe lingular division. They were considered to be middle lobe lingular syndrome. Three patients (22%) with localized varicose or cystic bronchiectasis had a history of pneumonia or pertussis in their infancy, so their bronchiectasis were considered secondary to infantile bronchopulmonary disease. Two patients (14%) had diffuse cystic bronchiectasis and were almost asymptomatic. They might be cases congenital bronchiectasis or Williams-Campbell syndrome. Pulmonary function tests were normal in most of the cases and sputum culture revealed no cases of persistent bacterial infection. These clinical features are quite different from those of bronchiectasis reported as sinobronchial syndrome, in which chronic productive cough, poor pulmonary function, persistent bacterial infection, etc. are significant. So we conclude that there are two distinct groups in bronchiectasis.

Clinical spectrum of bronchiectasis in children.

The prevalence of bronchiectasis decreased due to the effective use of vaccines and advances of antibiotic therapy after 1970. However, it remains an important long-term morbidity of lower respiratory tract infection in developing country. To evaluate the clinical features of bronchiectasis in a tertiary hospital, we collected 21 patients with a diagnosis of bronchiectasis in Taipei Veterans General Hospital from May, 1984 to Dec, 2001 in pediatric outpatient with the admission of age below 18 years old. The diagnosis was based on the history of recurrent cough with fetid sputum, hemoptysis, or recurrent lobar pneumonia for months at least and radiological findings of lobar infiltration, tram-track like patterns, bronchiolar dilatation or honeycomb patterns. The diagnostic examinations included chest plain radiography, bronchography and chest computed tomography (CT) scans. Respiratory tract infections were the commonest cause predisposing to bronchiectasis in our study. Tuberculosis is not rare in this study. In recent years, immunodeficiency disorders have been recognized. Most patients suffered from recurrent cough and fetid sputum for years before diagnosis was established. Hemoptysis was the second common symptom in our study. The plain chest radiograph of bronchiectasis revealed dilatation of bronchial trees with honeycomb pattern or infiltration only. In recent years, chest CT became the most accurate and being noninvasive diagnostic tool. The initial treatment was primarily medical conservative therapy. Only five patients in our cases underwent pulmonary resection due to persistent hemoptysis, recurrent bacterial pneumonia or pulmonary parenchyma destruction. Most patients still suffered from recurrent pneumonia or occasional exacerbation in the long-term follow-up. In conclusion, bronchiectasis is not uncommon in pediatric population in northern Taiwan. The history of recurrent cough with fetid sputum, hemoptysis, or recurrent pneumonia were the most important clues to early diagnosis of this disease. Early diagnosis and appropriate treatment are effective in order to prevent lung abscess, empyema and pneumothorax, bronchopleural fistula, hemoptysis or cor pulmonale.

Survey of the state of bronchography in Japan

Bronchography is not routinely done. We analyzed the state of bronchography with questionnaires returned from 57 hospitals. Bronchography is now done at 30 hospitals. The number done in 1992 ranged from 1 to 27 (median 3). Peripheral lung cancer and bronchiectasis were the two most frequent diseases for which bronchography was done. In other hospitals, bronchography was once done, but had been stopped. Two reasons for discontinuation of bronchography are: recent progress in radiographic diagnostic techniques such as high resolution CT, and discomfort of the patient. Now that propyliodone is no longer available, some hospitals may use iopydol-iopydone or iopamidol instead. It is necessary to elucidate the true need for bronchography and for an appropriate contrast medium to take the place of propyliodone.

Bronchiectasis: HRCT vs bronchography

Bronchiectasis: HRCT vs bronchography

The value of computed tomography in the diagnosis and management of bronchiectasis

In order to evaluate the usefulness of computed tomography (CT) in the diagnosis and management, as distinct from only the diagnosis, of bronchiectasis, we retrospectively reviewed the clinical, lung function, and radiological data of 38 patients suspected of having the disease. All had chest radiographs, CT scans, and bronchograms. The approach was to examine the radiological investigations with the clinical data in three stages: I, chest radiograph; II, CT; III, bronchography (BG), as if they were newly presenting cases. At the end of each stage, a decision was made either to proceed to the next stage or to stop because further investigation was considered unlikely to alter management. Apparent normality, equivocal abnormality, or unilateral abnormality were criteria for proceeding. Unfitness for surgery, unequivocal bilateral disease, or mild disease were criteria for stopping after a firm diagnosis had been made. We stopped at stage I in four patients (11%) because the chest radiograph showed bilateral bronchiectasis and two had poor lung function. We stopped at stage II in 15 patients (39%): 12 had bilateral disease on CT; three had unilateral disease on CT but their clinical features were so mild that BG was considered unjustified. Scrutiny of the CT and BG films of those patients who were judged not to require CT or BG in the retrospective review confirmed that these would not have altered their management. Of the remaining 19 patients who proceeded to stage III, BG was useful in 15 (39%) by confirming or refuting CT findings, but was not useful in four (11%) because of underfilling. We conclude that optimal use of chest radiographs and CT in patients suspected of having bronchiectasis can significantly reduce the necessity of performing BG.

Arterial oxygen saturation during bronchography via the fibreoptic bronchoscope.

Dans cette etude de 8 patients il se produit une desaturation arterielle de 20,5% et une diminution du debit expiratoire maximum de 50%

The accuracy of bronchography in bronchiectasis

The accuracy of bronchography in bronchiectasis

Bronchography and Fluoroscopy

Bronchography and Fluoroscopy

Bronchography with Bronchoscopy-To Reply

Bronchography with Bronchoscopy-To Reply

Risks of Lignocaine in Bronchography

Risks of Lignocaine in Bronchography

Bronchography

Propofol infusion syndrome is a rare condition that mainly affects critically ill patients who receive high doses of this hypnotic for a long time. We describe the case of a patient who presented twice hepatotoxicity in the immediate postoperative period of two surgeries in which she had received conventional doses of propofol during a short period of time. After studying the patient and monitoring her evolution, we arrived at a differential diagnosis of propofol infusion syndrome due to increased susceptibility. This syndrome should be considered in patients presenting hepatotoxicity in the immediate postoperative period, even when low doses of propofol have been administered.El síndrome por infusión de propofol es una entidad poco frecuente que afecta principalmente a pacientes críticos que reciben dosis elevadas de este hipnótico durante un tiempo prolongado. Describimos el caso de una paciente que presentó en dos ocasiones hepatotoxicidad en el periodo postoperatorio inmediato de dos cirugías en las que había recibido dosis convencionales de propofol en un periodo corto de tiempo. Después de su estudio, evolución y diagnóstico diferencial, se orienta como posible síndrome por infusión de propofol a causa de una susceptibilidad aumentada. Ante la aparición de una hepatotoxicidad en el postoperatorio inmediato debería tenerse presente esta entidad como posible causa aunque las dosis administradas sean bajas.

A technique for bronchography in children. An experience with 575 patients using topical anesthesia.

A technique for bronchography in children. An experience with 575 patients using topical anesthesia.

Pediatric Bronchography

Pediatric Bronchography

Bronchography using water-soluble oily propyliodone to demonstrate bronchiolar anatomy in chronic obstructive lung disease.

Bronchography using water-soluble oily propyliodone to demonstrate bronchiolar anatomy in chronic obstructive lung disease.

Propyliodone Aerosols in Bronchography and Laryngography

Propyliodone Aerosols in Bronchography and Laryngography

Pediatric Bronchography

Pediatric Bronchography