Skip to main content

Flexible Bronchoscopy

  • Chapter
  • First Online:
Interventions in Pulmonary Medicine

Abstract

Flexible bronchoscopy (FB) is the term that describes invasive, direct visualization of the airways via the flexible bronchoscope for diagnostic and therapeutic purposes. Flexible bronchoscopy is a safe procedure that is performed by pulmonologists and thoracic surgeons to inspect the proximal and distal airways, reaching the lung parenchyma. It is easy to use; it has minimal sedation requirements and a great safety profile, facts that account for its popularity.

Flexible bronchoscopy has drastically evolved as a diagnostic and therapeutic tool for pulmonologists over the last five decades. We discuss the evolution of the bronchoscope from its historical applications to today’s bronchoscopy, with all its technological advances. Also, we review indications, contraindications, patient preparation, and complications encountered. There are numerous adjunct modalities and tools available for use with the flexible bronchoscope for a wide variety of diagnostic and therapeutic indications, some of which are discussed in detail during the course of this chapter.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  1. Suratt PM, Smiddy JF, Gruber B. Deaths and complications associated with fiberoptic bronchoscopy. Chest. 1976;69(6):747–51.

    Article  CAS  PubMed  Google Scholar 

  2. Smyth CM, Stead RJ. Survey of flexible fibreoptic bronchoscopy in the United Kingdom. Eur Respir J. 2002;19(3):458–63.

    Article  CAS  PubMed  Google Scholar 

  3. Becker HD, Marsh BR. History of the rigid bronchoscope. In: Bolliger CTMP, editor. Interventional bronchoscopy. Basel: Karger; 2000. p. 2–15.

    Google Scholar 

  4. Ikeda S. The flexible bronchofiberscope. Keio J Med. 1968;17:1–16.

    Article  CAS  PubMed  Google Scholar 

  5. Miyazawa T, Miyazu Y, Iwamoto Y. Interventional flexible bronchoscopy. historical perspective. In: Beamis J, Mathur P, Mehta A, editors. Interventional pulmonary medicine lung biology in health and disease. New York: Marcel Dekker; 2004. p. 33–48.

    Chapter  Google Scholar 

  6. Hürter T, Hanrath P. Endobronchial sonography: feasibility and preliminary results. Thorax. 1992;47(7):565–7.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Becker HD. [Endobronchial ultrasound–a new perspective in bronchology]. Ultraschall Med 1996;17(3):106–12.

    Google Scholar 

  8. Yasufuku K, Chhajed PN, Sekine Y, Nakajima T, Chiyo M, Iyoda A, et al. Endobronchial ultrasound using a new convex probe: a preliminary study on surgically resected specimens. Oncol Rep. 2004;11(2):293–6.

    PubMed  Google Scholar 

  9. Yasufuku K, Chiyo M, Sekine Y, Chhajed PN, Shibuya K, Iizasa T, et al. Real-time endobronchial ultrasound-guided transbronchial needle aspiration of mediastinal and hilar lymph nodes. Chest. 2004;126(1):122–8.

    Article  PubMed  Google Scholar 

  10. Panchabhai TS, Mehta AC. Historical perspectives of bronchoscopy. Connecting the dots. Ann Am Thorac Soc. 2015;12(5):631–41.

    Article  PubMed  Google Scholar 

  11. Hsia DW, Tanner NT, Shamblin C, Mehta HJ, Silvestri GA, Musani AI. The latest generation in flexible bronchoscopes: a description and evaluation. J Bronchol Interv Pulmonol. 2013;20(4):357–62.

    Article  Google Scholar 

  12. Ernst A, Silvestri GA, Johnstone D, American College of Chest Physicians. Interventional pulmonary procedures: guidelines from the American College of Chest Physicians. Chest. 2003;123(5):1693–717.

    Article  PubMed  Google Scholar 

  13. Du Rand IA, Barber PV, Goldring J, Lewis RA, Mandal S, Munavvar M, et al. British Thoracic Society guideline for advanced diagnostic and therapeutic flexible bronchoscopy in adults. Thorax. 2011;66(Suppl 3):iii1–21.

    PubMed  Google Scholar 

  14. Bolliger CT, Mathur PN, Beamis JF, Becker HD, Cavaliere S, Colt H, et al. ERS/ATS statement on interventional pulmonology. European Respiratory Society/American Thoracic Society. Eur Respir J. 2002;19(2):356–73.

    Article  CAS  PubMed  Google Scholar 

  15. Prakash UB, Offord KP, Stubbs SE. Bronchoscopy in North America: the ACCP survey. Chest. 1991;100(6):1668–75.

    Article  CAS  PubMed  Google Scholar 

  16. Prakash UB, Stubbs SE. The bronchoscopy survey. Some reflections. Chest. 1991;100(6):1660–7.

    Article  CAS  PubMed  Google Scholar 

  17. Papin TA, Lynch JP, Weg JG. Transbronchial biopsy in the thrombocytopenic patient. Chest. 1985;88(4):549–52.

    Article  CAS  PubMed  Google Scholar 

  18. Ernst A, Eberhardt R, Wahidi M, Becker HD, Herth FJ. Effect of routine clopidogrel use on bleeding complications after transbronchial biopsy in humans. Chest. 2006;129(3):734–7.

    Article  PubMed  Google Scholar 

  19. Herth FJ, Becker HD, Ernst A. Aspirin does not increase bleeding complications after transbronchial biopsy. Chest. 2002;122(4):1461–4.

    Article  PubMed  Google Scholar 

  20. Stather DR, MacEachern P, Chee A, Tremblay A. Safety of endobronchial ultrasound-guided transbronchial needle aspiration for patients taking clopidogrel: a report of 12 consecutive cases. Respiration. 2012;83(4):330–4.

    Article  PubMed  Google Scholar 

  21. Matot I, Kramer MR, Glantz L, Drenger B, Cotev S. Myocardial ischemia in sedated patients undergoing fiberoptic bronchoscopy. Chest. 1997;112(6):1454–8.

    Article  CAS  PubMed  Google Scholar 

  22. American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non-Anesthesiologists. Practice guidelines for sedation and analgesia by non-anesthesiologists. Anesthesiology. 2002;96(4):1004–17.

    Article  Google Scholar 

  23. Beamis Jr J. Rigid bronchoscopy. In: Beamis J, Mathur P, editors. Interventional pulmonology New York: McGraw Hill; 1999. p. 17–28.

    Google Scholar 

  24. Jurado RL, Klein S. Infective endocarditis associated with fiberoptic bronchoscopy in a patient with mitral-valve prolapse. Clin Infect Dis. 1998;26(3):768–9.

    Article  CAS  PubMed  Google Scholar 

  25. Hanson RR, Zavala DC, Rhodes ML, Keim LW, Smith JD. Transbronchial biopsy via flexible fiberoptic bronchoscope; results in 164 patients. Am Rev Respir Dis. 1976;114(1):67–72.

    CAS  PubMed  Google Scholar 

  26. Kumar S, Agarwal R, Aggarwal AN, Gupta D, Jindal SK. Role of ultrasonography in the diagnosis and management of pneumothorax following transbronchial lung biopsy. J Bronchol Interv Pulmonol. 2015;22(1):14–9.

    Article  Google Scholar 

  27. Wahidi MM, Jain P, Jantz M, Lee P, Mackensen GB, Barbour SY, et al. American College of Chest Physicians consensus statement on the use of topical anesthesia, analgesia, and sedation during flexible bronchoscopy in adult patients. Chest. 2011;140(5):1342–50.

    Article  CAS  PubMed  Google Scholar 

  28. Choi CM, Yoon HI, Lee SM, Yoo CG, Kim YW, Han SK, et al. Oral insertion of a flexible bronchoscope is associated with less discomfort than nasal insertion for Korean patients. Int J Tuberc Lung Dis. 2005;9(3):344–8.

    CAS  PubMed  Google Scholar 

  29. Beaudoin S, Ferland N, Martel S, Delage A. Feasibility of using the nasal route for linear endobronchial ultrasound. Lung. 2014;192(6):921–6.

    Article  PubMed  Google Scholar 

  30. Credle W, Smiddy J, Elliot R. Complications of fibreoptic bronchoscopy. Am Rev Respir Dis. 1976;109:67–72.

    Google Scholar 

  31. Dubrawsky C, Awe RJ, Jenkins DE. The effect of bronchofiberscopic examination on oxygenation status. Chest. 1975;67(2):137–40.

    Article  CAS  PubMed  Google Scholar 

  32. Katz A, Michelson E, Stawicki J, Holford F. Cardiac arrythmias: frequency during fi beroptic bronchoscopy and correlation with hypoxemia. Arch Intern Med. 1981;141:603–6.

    Article  CAS  PubMed  Google Scholar 

  33. Davies L, Mister R, Spence DP, Calverley PM, Earis JE, Pearson MG. Cardiovascular consequences of fibreoptic bronchoscopy. Eur Respir J. 1997;10(3):695–8.

    CAS  PubMed  Google Scholar 

  34. Reddy C, Majid A, Michaud G, Feller-Kopman D, Eberhardt R, Herth F, et al. Gas embolism following bronchoscopic argon plasma coagulation: a case series. Chest. 2008;134(5):1066–9.

    Article  PubMed  Google Scholar 

  35. Reynolds HY, Newball HH. Analysis of proteins and respiratory cells obtained from human lungs by bronchial lavage. J Lab Clin Med. 1974;84(4):559–73.

    CAS  PubMed  Google Scholar 

  36. Haslam PL, Baughman RP. Report of ERS Task Force: guidelines for measurement of acellular components and standardization of BAL. Eur Respir J. 1999;14(2):245–8.

    Article  CAS  PubMed  Google Scholar 

  37. Heron M, Grutters JC, ten Dam-Molenkamp KM, Hijdra D, van Heugten-Roeling A, Claessen AM, et al. Bronchoalveolar lavage cell pattern from healthy human lung. Clin Exp Immunol. 2012;167(3):523–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Raghu G, Mageto YN, Lockhart D, Schmidt RA, Wood DE, Godwin JD. The accuracy of the clinical diagnosis of new-onset idiopathic pulmonary fibrosis and other interstitial lung disease: a prospective study. Chest. 1999;116(5):1168–74.

    Article  CAS  PubMed  Google Scholar 

  39. Collard HR, King TE. Demystifying idiopathic interstitial pneumonia. Arch Intern Med. 2003;163(1):17–29.

    Article  PubMed  Google Scholar 

  40. Baughman RP, Dohn MN, Frame PT. The continuing utility of bronchoalveolar lavage to diagnose opportunistic infection in AIDS patients. Am J Med. 1994;97(6):515–22.

    Article  CAS  PubMed  Google Scholar 

  41. Joos L, Chhajed PN, Wallner J, Battegay M, Steiger J, Gratwohl A, et al. Pulmonary infections diagnosed by BAL: a 12-year experience in 1066 immunocompromised patients. Respir Med. 2007;101(1):93–7.

    Article  PubMed  Google Scholar 

  42. Jain P, Sandur S, Meli Y, Arroliga AC, Stoller JK, Mehta AC. Role of flexible bronchoscopy in immunocompromised patients with lung infiltrates. Chest. 2004;125(2):712–22.

    Article  PubMed  Google Scholar 

  43. Andersen HA, Fontana RS, Harrison EG. Transbronchoscopic lung biopsy in diffuse pulmonary disease. Dis Chest. 1965;48:187–92.

    Article  CAS  PubMed  Google Scholar 

  44. Andersen HA, Fontana RS. Transbronchoscopic lung biopsy for diffuse pulmonary diseases: technique and results in 450 cases. Chest. 1972;62(2):125–8.

    Article  CAS  PubMed  Google Scholar 

  45. Descombes E, Gardiol D, Leuenberger P. Transbronchial lung biopsy: an analysis of 530 cases with reference to the number of samples. Monaldi Arch Chest Dis. 1997;52(4):324–9.

    CAS  PubMed  Google Scholar 

  46. Ensminger SA, Prakash UB. Is bronchoscopic lung biopsy helpful in the management of patients with diffuse lung disease? Eur Respir J. 2006;28(6):1081–4.

    Article  CAS  PubMed  Google Scholar 

  47. Bradley B, Branley HM, Egan JJ, Greaves MS, Hansell DM, Harrison NK, et al. Interstitial lung disease guideline: the British Thoracic Society in collaboration with the Thoracic Society of Australia and New Zealand and the Irish Thoracic Society. Thorax. 2008;63(Suppl 5):v1–58.

    PubMed  Google Scholar 

  48. Hopkins PM, Aboyoun CL, Chhajed PN, Malouf MA, Plit ML, Rainer SP, et al. Prospective analysis of 1,235 transbronchial lung biopsies in lung transplant recipients. J Heart Lung Transplant. 2002;21(10):1062–7.

    Article  PubMed  Google Scholar 

  49. Simpson FG, Arnold AG, Purvis A, Belfield PW, Muers MF, Cooke NJ. Postal survey of bronchoscopic practice by physicians in the United Kingdom. Thorax. 1986;41(4):311–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Rademacher J, Suhling H, Greer M, Haverich A, Welte T, Warnecke G, et al. Safety and efficacy of outpatient bronchoscopy in lung transplant recipients – a single centre analysis of 3,197 procedures. Transplant Res. 2014;3:11.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Wang KP, Terry P, Marsh B. Bronchoscopic needle aspiration biopsy of paratracheal tumors. Am Rev Respir Dis. 1978;118(1):17–21.

    CAS  PubMed  Google Scholar 

  52. Wang KP, Haponik EF, Gupta PK, Erozan YS. Flexible transbronchial needle aspiration. Technical considerations. Ann Otol Rhinol Laryngol. 1984;93(3 Pt 1):233–6.

    Article  CAS  PubMed  Google Scholar 

  53. Chin R Jr, McCain TW, Lucia MA, Cappellari JO, Adair NE, Lovato JF, et al. Transbronchial needle aspiration in diagnosing and staging lung cancer: how many aspirates are needed? Am J Respir Crit Care Med. 2002;166(3):377–81.

    Article  PubMed  Google Scholar 

  54. Holty JE, Kuschner WG, Gould MK. Accuracy of transbronchial needle aspiration for mediastinal staging of non-small cell lung cancer: a meta-analysis. Thorax. 2005;60(11):949–55.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Baaklini WA, Reinoso MA, Gorin AB, Sharafkaneh A, Manian P. Diagnostic yield of fiberoptic bronchoscopy in evaluating solitary pulmonary nodules. Chest. 2000;117(4):1049–54.

    Article  CAS  PubMed  Google Scholar 

  56. Katis K, Inglesos E, Zachariadis E, Palamidas P, Paraskevopoulos I, Sideris G, et al. The role of transbronchial needle aspiration in the diagnosis of peripheral lung masses or nodules. Eur Respir J. 1995;8(6):963–6.

    CAS  PubMed  Google Scholar 

  57. Boonsarngsuk V, Kanoksil W, Laungdamerongchai S. Diagnosis of peripheral pulmonary lesions with radial probe endobronchial ultrasound-guided bronchoscopy. Arch Bronconeumol. 2014;50(9):379–83.

    Article  PubMed  Google Scholar 

  58. Schreiber G, McCrory DC. Performance characteristics of different modalities for diagnosis of suspected lung cancer: summary of published evidence. Chest. 2003;123(1 Suppl):115S–28S.

    Article  PubMed  Google Scholar 

  59. Casal RF, Lazarus DR, Kuhl K, Nogueras-González G, Perusich S, Green LK, et al. Randomized trial of endobronchial ultrasound-guided transbronchial needle aspiration under general anesthesia versus moderate sedation. Am J Respir Crit Care Med. 2015;191(7):796–803.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Gu P, Zhao YZ, Jiang LY, Zhang W, Xin Y, Han BH. Endobronchial ultrasound-guided transbronchial needle aspiration for staging of lung cancer: a systematic review and meta-analysis. Eur J Cancer. 2009;45(8):1389–96.

    Article  PubMed  Google Scholar 

  61. Nakajima T, Yasufuku K, Takahashi R, Shingyoji M, Hirata T, Itami M, et al. Comparison of 21-gauge and 22-gauge aspiration needle during endobronchial ultrasound-guided transbronchial needle aspiration. Respirology. 2011;16(1):90–4.

    Article  PubMed  Google Scholar 

  62. Yarmus LB, Akulian J, Lechtzin N, Yasin F, Kamdar B, Ernst A, et al. Comparison of 21-gauge and 22-gauge aspiration needle in endobronchial ultrasound-guided transbronchial needle aspiration: results of the American College of Chest Physicians Quality Improvement Registry, Education, and Evaluation Registry. Chest. 2013;143(4):1036–43.

    Article  PubMed  Google Scholar 

  63. Jeyabalan A, Bhatt N, Plummeridge MJ, Medford AR. Adequacy of endobronchial ultrasound-guided transbronchial needle aspiration samples processed as histopathological samples for genetic mutation analysis in lung adenocarcinoma. Mol Clin Oncol. 2016;4(1):119–25.

    Article  PubMed  Google Scholar 

  64. Adams K, Shah PL, Edmonds L, Lim E. Test performance of endobronchial ultrasound and transbronchial needle aspiration biopsy for mediastinal staging in patients with lung cancer: systematic review and meta-analysis. Thorax. 2009;64(9):757–62.

    Article  CAS  PubMed  Google Scholar 

  65. Varela-Lema L, Fernández-Villar A, Ruano-Ravina A. Effectiveness and safety of endobronchial ultrasound-transbronchial needle aspiration: a systematic review. Eur Respir J. 2009;33(5):1156–64.

    Article  CAS  PubMed  Google Scholar 

  66. Detterbeck FC, Lewis SZ, Diekemper R, Addrizzo-Harris D, Alberts WM. Executive Summary: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013;143(5 Suppl):7S–37S.

    Article  CAS  PubMed  Google Scholar 

  67. Ge X, Guan W, Han F, Guo X, Jin Z. Comparison of endobronchial ultrasound-guided fine needle aspiration and video-assisted mediastinoscopy for mediastinal staging of lung cancer. Lung. 2015;193(5):757–66.

    Article  PubMed  Google Scholar 

  68. Grosu HB, Iliesiu M, Caraway NP, Medeiros LJ, Lei X, Jimenez CA, et al. Endobronchial ultrasound-guided transbronchial needle aspiration for the diagnosis and subtyping of lymphoma. Ann Am Thorac Soc. 2015;12(9):1336–44.

    Article  PubMed  Google Scholar 

  69. Wong M, Yasufuku K, Nakajima T, Herth FJ, Sekine Y, Shibuya K, et al. Endobronchial ultrasound: new insight for the diagnosis of sarcoidosis. Eur Respir J. 2007;29(6):1182–6.

    Article  CAS  PubMed  Google Scholar 

  70. Oki M, Saka H, Kitagawa C, Tanaka S, Shimokata T, Kawata Y, et al. Real-time endobronchial ultrasound-guided transbronchial needle aspiration is useful for diagnosing sarcoidosis. Respirology. 2007;12(6):863–8.

    Article  PubMed  Google Scholar 

  71. Garwood S, Judson MA, Silvestri G, Hoda R, Fraig M, Doelken P. Endobronchial ultrasound for the diagnosis of pulmonary sarcoidosis. Chest. 2007;132(4):1298–304.

    Article  PubMed  Google Scholar 

  72. Tournoy KG, Bolly A, Aerts JG, Pierard P, De Pauw R, Leduc D, et al. The value of endoscopic ultrasound after bronchoscopy to diagnose thoracic sarcoidosis. Eur Respir J. 2010;35(6):1329–35.

    Article  CAS  PubMed  Google Scholar 

  73. Gupta D, Dadhwal DS, Agarwal R, Gupta N, Bal A, Aggarwal AN. Endobronchial ultrasound-guided transbronchial needle aspiration vs conventional transbronchial needle aspiration in the diagnosis of sarcoidosis. Chest. 2014;146(3):547–56.

    Article  PubMed  Google Scholar 

  74. Chen A, Chenna P, Loiselle A, Massoni J, Mayse M, Misselhorn D. Radial probe endobronchial ultrasound for peripheral pulmonary lesions. A 5-year institutional experience. Ann Am Thorac Soc. 2014;11(4):578–82.

    Article  PubMed  Google Scholar 

  75. Steinfort DP, Khor YH, Manser RL, Irving LB. Radial probe endobronchial ultrasound for the diagnosis of peripheral lung cancer: systematic review and meta-analysis. Eur Respir J. 2011;37(4):902–10.

    Article  CAS  PubMed  Google Scholar 

  76. Steinfort DP, Vincent J, Heinze S, Antippa P, Irving LB. Comparative effectiveness of radial probe endobronchial ultrasound versus CT-guided needle biopsy for evaluation of peripheral pulmonary lesions: a randomized pragmatic trial. Respir Med. 2011;105(11):1704–11.

    Article  PubMed  Google Scholar 

  77. Kikuchi E, Yamazaki K, Sukoh N, Kikuchi J, Asahina H, Imura M, et al. Endobronchial ultrasonography with guide-sheath for peripheral pulmonary lesions. Eur Respir J. 2004;24(4):533–7.

    Article  CAS  PubMed  Google Scholar 

  78. Yamada N, Yamazaki K, Kurimoto N, Asahina H, Kikuchi E, Shinagawa N, et al. Factors related to diagnostic yield of transbronchial biopsy using endobronchial ultrasonography with a guide sheath in small peripheral pulmonary lesions. Chest. 2007;132(2):603–8.

    Article  PubMed  Google Scholar 

  79. Eberhardt R, Anantham D, Ernst A, Feller-Kopman D, Herth F. Multimodality bronchoscopic diagnosis of peripheral lung lesions: a randomized controlled trial. Am J Respir Crit Care Med. 2007;176(1):36–41.

    Article  PubMed  Google Scholar 

  80. Ishida T, Asano F, Yamazaki K, Shinagawa N, Oizumi S, Moriya H, et al. Virtual bronchoscopic navigation combined with endobronchial ultrasound to diagnose small peripheral pulmonary lesions: a randomised trial. Thorax. 2011;66(12):1072–7.

    Article  PubMed  PubMed Central  Google Scholar 

  81. Matsuno Y, Asano F, Shindoh J, Abe T, Shiraki A, Ando M, et al. CT-guided ultrathin bronchoscopy: bioptic approach and factors in predicting diagnosis. Intern Med. 2011;50(19):2143–8.

    Article  PubMed  Google Scholar 

  82. Rivera MP, Mehta AC, American College of Chest Physicians. Initial diagnosis of lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007;132(3 Suppl):131S–48S.

    Article  PubMed  Google Scholar 

  83. Oki M, Saka H, Ando M, Asano F, Kurimoto N, Morita K, et al. Ultrathin bronchoscopy with multimodal devices for peripheral pulmonary lesions. A randomized trial. Am J Respir Crit Care Med. 2015;192(4):468–76.

    Article  PubMed  Google Scholar 

  84. Asano F, Shinagawa N, Ishida T, Shindoh J, Anzai M, Tsuzuku A, et al. Virtual bronchoscopic navigation combined with ultrathin bronchoscopy. A randomized clinical trial. Am J Respir Crit Care Med. 2013;188(3):327–33.

    Article  PubMed  Google Scholar 

  85. Poletti V, Casoni GL, Gurioli C, Ryu JH, Tomassetti S. Lung cryobiopsies: a paradigm shift in diagnostic bronchoscopy? Respirology. 2014;19(5):645–54.

    Article  PubMed  Google Scholar 

  86. Fruchter O, Fridel L, Rosengarten D, Rahman NA, Kramer MR. Transbronchial cryobiopsy in immunocompromised patients with pulmonary infiltrates: a pilot study. Lung. 2013;191(6):619–24.

    Article  PubMed  Google Scholar 

  87. Ravaglia C, Bonifazi M, Wells AU, Tomassetti S, Gurioli C, Piciucchi S, et al. Safety and diagnostic yield of transbronchial lung cryobiopsy in diffuse parenchymal lung diseases: a comparative study versus video-assisted thoracoscopic lung biopsy and a systematic review of the literature. Respiration. 2016;91(3):215–27.

    Article  PubMed  Google Scholar 

  88. Diaz-Jimenez J, Rodriguez A. Broncoscopia rigida. In: Diaz-Jimenez J, Rodriguez A, editors. Neumologia intervencionista. Barcelona: Ediciones Gea; 2000. p. 1–16.

    Google Scholar 

  89. Diaz-Jimenez JP, Ballarin JI, Muñoz EF, Kovitz KL, Serrano MJ, Shirakura K. Video endoscopy for laser photoresection in tracheobronchial pathology: some considerations after 9 years experience with 2105 treatments. Diagn Ther Endosc. 1995;2(2):79–87.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  90. Cavaliere S, Foccoli P, Farina PL. Nd:YAG laser bronchoscopy. A five-year experience with 1,396 applications in 1,000 patients. Chest. 1988;94(1):15–21.

    Article  CAS  PubMed  Google Scholar 

  91. Lee P, Mehta A. Therapeutic flexible bronchoscopy: overview. In: Beamis J, Mathur P, Mehta A, editors. Interventional pulmonary medicine, vol. 189. New York: Marcel Dekker; 2004.

    Google Scholar 

  92. Brutinel WM, Cortese DA, McDougall JC, Gillio RG, Bergstralh EJ. A two-year experience with the neodymium-YAG laser in endobronchial obstruction. Chest. 1987;91(2):159–65.

    Article  CAS  PubMed  Google Scholar 

  93. Katlic MR, Burick AJ, Lucchino DB. Experiences with laser bronchoscopy. Pa Med. 1991;94(6):24–7.

    CAS  PubMed  Google Scholar 

  94. Marel M, Pekarek Z, Spasova I, Pafko P, Schutzner J, Betka J, et al. Management of benign stenoses of the large airways in the university hospital in Prague, Czech Republic, in 1998-2003. Respiration. 2005;72(6):622–8.

    Article  PubMed  Google Scholar 

  95. Van Boxem TJ, Venmans BJ, Schramel FM, van Mourik JC, Golding RP, Postmus PE, et al. Radiographically occult lung cancer treated with fibreoptic bronchoscopic electrocautery: a pilot study of a simple and inexpensive technique. Eur Respir J. 1998;11(1):169–72.

    Article  PubMed  Google Scholar 

  96. De la Cruz L, Pereira A, Krieger B. Use of endobronchial electrocautery for the palliation of airway obstruction due to metastases from nonpulmonary malignancies. J Bronchol Interv Pulmonol. 2006;13:124–7.

    Google Scholar 

  97. Sutedja G, van Kralingen K, Schramel FM, Postmus PE. Fibreoptic bronchoscopic electrosurgery under local anaesthesia for rapid palliation in patients with central airway malignancies: a preliminary report. Thorax. 1994;49(12):1243–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  98. Sutedja T, Van Boxem T, Schramel F. Endobronchial electrocautery is an excellent alternative for Nd:YAG laser to treat airway tumors. J Bronchol Interv Pulmonol. 1997;4:101–5.

    Google Scholar 

  99. Reichle G, Freitag L, Kullmann H-J. Argon plasma coagulation in bronchology: a new methoddalternative or complementary? J Bronchol Interv Pulmonol. 2000;7:109–17.

    Google Scholar 

  100. Chan AL, Tharratt RS, Siefkin AD, Albertson TE, Volz WG, Allen RP. Nd:YAG laser bronchoscopy. Rigid or fiberoptic mode? Chest. 1990;98(2):271–5.

    Article  CAS  PubMed  Google Scholar 

  101. Maiwand MO, Evans JM, Beeson JE. The application of cryosurgery in the treatment of lung cancer. Cryobiology. 2004;48(1):55–61.

    Article  CAS  PubMed  Google Scholar 

  102. Vergnon JM, Schmitt T, Alamartine E, Barthelemy JC, Fournel P, Emonot A. Initial combined cryotherapy and irradiation for unresectable non-small cell lung cancer. Preliminary results. Chest. 1992;102(5):1436–40.

    Article  CAS  PubMed  Google Scholar 

  103. Diaz-Jiménez JP, Martínez-Ballarín JE, Llunell A, Farrero E, Rodríguez A, Castro MJ. Efficacy and safety of photodynamic therapy versus Nd-YAG laser resection in NSCLC with airway obstruction. Eur Respir J. 1999;14(4):800–5.

    Article  PubMed  Google Scholar 

  104. Rodriguez A, Diaz-Jimenez J, Edell E. Silicone stents versus metal stents for management of benign tracheobronchial disease Con: metal stents. J Bronchol Interv Pulmonol. 2000;7:184–7.

    Google Scholar 

  105. Food and Drug Administration. FDA public health notification: complications from metallic tracheal stents in patients with benign airway disorders. 2005. Available from: http://www.fda.gov/cdrh/safety/072905-tracheal.html.

  106. Lund ME, Force S. Airway stenting for patients with benign airway disease and the Food and Drug Administration advisory: a call for restraint. Chest. 2007;132(4):1107–8.

    Article  PubMed  Google Scholar 

  107. Mughal MM, Gildea TR, Murthy S, Pettersson G, DeCamp M, Mehta AC. Short-term deployment of self-expanding metallic stents facilitates healing of bronchial dehiscence. Am J Respir Crit Care Med. 2005;172(6):768–71.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tarek Dammad MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Dammad, T., Jalil, B.A. (2018). Flexible Bronchoscopy. In: Díaz-Jimenez, J., Rodriguez, A. (eds) Interventions in Pulmonary Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-58036-4_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-58036-4_2

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-58035-7

  • Online ISBN: 978-3-319-58036-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics