Bronchoscopy under General Anaesthesia and its Application: (A cuffed bronchoscopy in an emergency, haemorrhage in particular)

Summary

Since 1957, a newly designed and developed cuffed bronchoscope with general anaesthesia has been used for the examination and treatment of over 2,500 patients at our institute. The examination of bronchoscopy under general anaesthesia is carried out using rigid bronchofiberscopes and flexible bronchofiberscopes through a cuffed straight tracheal tube. Through this tube, bronchial brushing, punch biopsy and transbronchial needle biopsy can be done in combination with routine observation. As a rule, the clinical diagnosis and indication of operation are determined in reference to the findings of bronchial epithelium as well as the results of cytological and histological examinations of brushing smear or punch biopsy. On the other hand, in the curative aspect, not only the securing of the airway under direct view even through active bleeding in bronchial lumen, but also sucking in the bronchial lumen or inflating the lung, can be performed easily and accurately during the operation or in an emergency through this bronchoscope. So, it seems that the ultimate value of this method cannot be evaluated. To further emphasize the usefulness of the cuffed bronchoscope, the author reports the details of several significant cases in the institute's experience, including a case which developed an intrabronchial bleeding and was successfully treated using this method, thus saving the patient's life.

Zusammenfassung

Seit 1957 wurde ein neu entwickeltes Bronchoskop in Allgemeinnarkose bei über 2500 Patienten eingesetzt, wobei starres und flexibles Bronchofiberskop durch einen geraden Trachealtubus mit Manschette eingeführt werden. Durch diesen Tubus ist neben der üblichen Inspektion eine Abrasivzytologie, eine Stanzbiopsie und eine transbronchiale Nadelbiopsie möglich. Selbst bei einer aktiven Blutung ins Bronchiallumen können mit diesem Instrument die Luftwege offengehalten werden; eine Absaugung ist ebenso möglich wie eine Insufflation der Lunge während der Untersuchung. Am Beispiel eines Falles einer akuten intrabronchialen Blutung wird der Wert der Methode eindrucksvoll belegt.

Key-Words

Bronchoscopy - general anaesthesia - flexible bronchoscope - bronchofiberscope - intrabronchial bleeding