https://doi.org/10.4081/monaldi.2022.2161
A 12-year experience in endobronchial intervention using rigid bronchoscopy - account of a tertiary referral centre
Submitted: December 7, 2021
Accepted: March 3, 2022
Published: March 24, 2022
Accepted: March 3, 2022
Abstract Views: 1099
PDF: 310
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
We describe our experience of rigid bronchoscopy and endobronchial intervention at a single tertiary centre over a 12-year period. All rigid bronchoscopy procedures between July 2008 and July 2020 (inclusive) were reviewed. All procedures were performed in cardiothoracic theatres by a designated team under general anaesthesia. 2135 rigid bronchoscopies were performed on 1301 patients aged between 18 and 93 years. Complications occurred in 24 (1.12%) procedures. There was one fatality (0.05%). Haemorrhage >100mls occurred in seven (0.33%) all of which were successfully managed endobronchially. Ten procedures (0.5%) were complicated by pneumothorax and an intercostal drain was required for eight. Five patients required intensive care admission post operatively, all of whom were subsequently discharged from hospital. One patient had stent migration. To the best of our knowledge, this is amongst the largest single centre collection of data available for endobronchial intervention using rigid bronchoscopy. We show that rigid bronchoscopy is a safe and effective procedure when performed in a high-volume specialist centre with designated lists involving a specialist multidisciplinary team.
Alraiyes A, Machuzak M. Rigid bronchoscopy. Semin Respir Crit Care Med 2014;35:671–80.
DOI: https://doi.org/10.1055/s-0034-1395500
Semaan R, Yarmus L. Rigid bronchoscopy and silicone stents in the management of central airway obstruction. J Thorac Dis 2015;7:352–62.
Diaz-Mendoza J, Peralta A, Debiane L, Simoff M. Rigid bronchoscopy. Am J Respir Crit Care Med 2018;39:674–84.
DOI: https://doi.org/10.1055/s-0038-1676647
Kazakov J, Khereba M, Thiffault V, et al. Modified technique for tracheobronchial Y-stent insertion using flexible bronchoscope for stent guidance. J Thorac Cardiovasc Surg 2015;150:1005–9.
DOI: https://doi.org/10.1016/j.jtcvs.2015.07.016
McGrath E, Warriner D, Anderson P. The insertion of self expanding metal stents with flexible bronchoscopy under sedation for malignant tracheobronchial stenosis: a single-center retrospective analysis. Arch Bronconeumol 2012;48:43–8.
DOI: https://doi.org/10.1016/j.arbr.2011.09.005
Dutau H, Vandemoortele T, Breen D. Rigid bronchoscopy. Clin Chest Med 2013;34:427–35.
DOI: https://doi.org/10.1016/j.ccm.2013.04.003
Stahl D, Richard K, Papadimos T. Complications of bronchoscopy: A concise synopsis. Int J Crit Illn Inj Sci 2015;5:189–95.
DOI: https://doi.org/10.4103/2229-5151.164995
Drummond M, Magalhaes A, Hespanhol V, Marques A. Rigid bronchoscopy: Complications in a university hospital. J Bronchol Interv Pulmonol 2010;10:177–81.
DOI: https://doi.org/10.1097/00128594-200307000-00003
Evans E, Biro P, Bedforth N. Jet ventilation. Contin Educ Anaesthesia Crit Care Pain 2007;7:2–5.
DOI: https://doi.org/10.1093/bjaceaccp/mkl061
Ranu H, Gatheral T, Sheth A, et al. Successful endobronchial seal of surgical bronchopleural fistulas using bioglue. Ann Thorac Surg 2009;88:1691–2.
DOI: https://doi.org/10.1016/j.athoracsur.2009.03.012
Ost D, Ernst A, Grosu H, et al. Complications following therapeutic bronchoscopy for malignant central airway obstruction: results of the AQuIRE registry. Chest 2015;148:450–71.
DOI: https://doi.org/10.1378/chest.14-1530
Lukomsky G, Ovchinnikov A, Bilal A. Complications of bronchoscopy: comparison of rigid bronchoscopy under general anesthesia and flexible fiberoptic bronchoscopy under topical anesthesia. Chest 1981;79:316–21.
DOI: https://doi.org/10.1378/chest.79.3.316
Fortin M, Yarmus L, Rendina EA, et al. Multi-institutional retrospective analysis of adverse eventsfollowing rigid tracheobronchoscopy. Respirilogy 2021;26:87–91.
DOI: https://doi.org/10.1111/resp.13873
Daneshvar C, Falconer W, Ahmed M, et al. Prevalence and outcome of central airway obstruction in patients with lung cancer. BMJ Open Respir Res 2019;6:e000429.
DOI: https://doi.org/10.1136/bmjresp-2019-000429
Oviatt P, Stather D, Michaud G, et al. Exercise capacity, lung function, and quality of life after interventional bronchoscopy. J Thorac Oncol 2011;6:38–42.
DOI: https://doi.org/10.1097/JTO.0b013e3181f8a298
Madden B, Sheth A, Walters N, et al. Does large airway intervention for patients with malignant disease result in early clinical benefit? Am Rev Respir Crit Care Med 2017;175:A622.
Chhajed P, Eberhardt R, Dienemann H, et al. Therapeutic bronchoscopy interventions before surgical resection of lung cancer. Ann Thorac Surg 2006;81:1839–43.
DOI: https://doi.org/10.1016/j.athoracsur.2005.11.054
Wood D. Airway stenting. Chest Surg Clin N Am 2003;13:211–29.
DOI: https://doi.org/10.1016/S1052-3359(03)00029-2
Lo C, Hsu A, Eng P. Endobronchial stenting in patients requiring mechanical ventilation for major airway obstruction. Ann Acad Med Singapore 2000;29:66–70.
Madden B, Loke T, Sheth A. Do expandable metallic airway stents have a role in the management of patients with benign tracheobronchial disease? Ann Thorac Surg 2006;82:274–8.
DOI: https://doi.org/10.1016/j.athoracsur.2006.02.028
Xiong X-F, Xu L, Fan L, et al. Long term follow up of self expandable metallic stents in benign tracheobronchial stenosis: A retrospective study. BMC Pulm Med 2019;19:33.
DOI: https://doi.org/10.1186/s12890-019-0793-y
Noppen M, Stratakos G, Amjadi K, et al. Stenting allows weaning and extubation in ventilator- or tracheostomy dependency secondary to benign airway disease. Respir Med 2007;101:139–45.
DOI: https://doi.org/10.1016/j.rmed.2006.03.037
Zhou C, Hu Y, Xiao Y, Yin W. Current treatment of tracheoesophageal fistula. Ther Adv Respir Dis 2017;11:173–80.
DOI: https://doi.org/10.1177/1753465816687518
Lunn W, Feller-Kopman D, Wahidi M, et al. Endoscopic removal of metallic airway stents. Chest 2005;127:2106 –12.
DOI: https://doi.org/10.1378/chest.127.6.2106
Ranu H, Evans J, Sheth A, Madden B. Removal of long-term tracheal stents with excellent tracheal healing. Ann Thorac Surg 2010;89:598–9.
DOI: https://doi.org/10.1016/j.athoracsur.2009.07.040
Konda S, Narayan S, Molanguri P, Madden B. Rigid bronchoscopy-essential experience for respiratory trainees? Eur Respir J 2015;46:PA316.
DOI: https://doi.org/10.1183/13993003.congress-2015.PA316
How to Cite
Bartlett-Pestell, Sam, James May, Ashutosh Sharma, Sunshine Alonzo, Natalie Barnes, and Brendan P. Madden. 2022. “A 12-Year Experience in Endobronchial Intervention Using Rigid Bronchoscopy - Account of a Tertiary Referral Centre”. Monaldi Archives for Chest Disease 92 (4). https://doi.org/10.4081/monaldi.2022.2161.
Copyright (c) 2022 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
