Bronchoscopy – application in the diagnosis and treatment of lung cancer

Dazhong Net·Poster News reporter Xu Ling and Wu Zonghao reported from Jinan

April 15th to 21st this year is the 28th National Cancer Prevention Publicity Week. The theme is “Early Action for Cancer Prevention and Control”. In order to let everyone know more about cancer prevention and health knowledge and improve the quality of life, and Poster News have recently invited three relevant experts from the Third Affiliated Hospital of Shandong First Medical University to explain the early symptoms of cancer, pulmonary nodules, etc. The application of bronchoscopy in lung cancer, breast cancer and other related knowledge.

Long Fei, director, MD, and chief physician of the Department of Respiratory and Critical Care Medicine of the hospital, was a guest at the Poster News Studio, explaining the development history and working principle of bronchoscopy, and emphatically explained the trachea Application of mirror in lung cancer.

First of all, Long Fei introduced what a bronchoscope is, he said, “Bronchoscopic is a very common examination and treatment method in respiratory medicine. The slender and soft end is equipped with a light source and a tube with a miniature electronic camera. It enters the vocal cords, main trachea, bronchi, and lung lobes through the oral cavity or nasal cavity, and finally cooperates with the TV system to observe and sample the trachea and lung tissue.” 1897 In 1999, Killian of Germany used esophagoscope to remove bony foreign bodies from the trachea for the first time, creating a precedent for bronchoscopy technology. In the early 1970s, my country began to introduce fiberoptic bronchoscopes, which have now developed into electronic bronchoscopes and are popularized in primary hospitals.

“Bronchoscopically can be used for both diagnosis and treatment.” Long Fei introduced that in terms of diagnosis, it can be used for unexplained hemoptysis, chronic cough, unexplained localized wheezing, vocal cord paralysis, Sputum cytology proved to be cancer, imaging abnormalities, preoperative lung cancer and so on. Bronchoscopy is irreplaceable in the diagnosis and treatment of lung cancer. Bronchoscopy can obtain tumor pathology and cytology through mucosal biopsy, brush, bronchoalveolar lavage and other techniques. At the same time, a flexible puncture needle can be used to biopsy through bronchoscopy. The channel enters the airway, penetrates the airway wall, and obtains cytological and pathological specimens of extraluminal lesions for the purpose of diagnosing diseases.

In terms of treatment, many patients with advanced lung cancer have mediastinal hilar lymph node enlargement and the tumor directly invades the airway, resulting in large airway stenosis, which in turn causes severe dyspnea and obstructive atelectasis. Treatable pulmonary infection. If the above problems occur, we can use bronchoscopy to reopen the narrowed airway to quickly relieve the patient’s dyspnea. Later, local and systemic treatment can significantly prolong the patient’s survival period and improve the patient’s quality of life.

According to Long Fei’s introduction, bronchoscopes are divided into flexible bronchoscopes and rigid bronchoscopes. It is safe and does not require general anesthesia. The disadvantage is that the bleeding is difficult to control and the efficiency is low. The advantages of rigid bronchoscope are large lumen and high efficiency; placement of silicone and expandable stents; effective treatment of massive bleeding; direct cutting of tumors; simultaneous oxygen supply and ventilation; safety is its greatest advantage. The disadvantage is that the method is complex, requires high technical requirements, requires general anesthesia, requires the cooperation of an anesthesiologist, and needs to be performed in the operating room. Now most of our interventional treatment patients are carried out through rigid bronchoscope, which is safe and less painful for patients.

During the interview, Director Long Fei introduced the application of bronchoscopy with the help of typical clinical cases of patients, and the patients had good therapeutic effects.

The patient suffered from severe dyspnea due to airway metastasis after operation. Bronchoscopy revealed severe airway obstruction. Interventional therapy was used to completely remove the tumor in the airway, and local photodynamic therapy was given after the resection to achieve long-term effective control. Intra-airway tumor resection combined with local photodynamic therapy is effective for some advanced tumors.