Objective:To study the improving effect of sputum aspiration combined with bronchoalveolar lavage by fiber bronchoscope on the condition and inflammation in lung cancer patients with postoperative pulmonary infection....Objective:To study the improving effect of sputum aspiration combined with bronchoalveolar lavage by fiber bronchoscope on the condition and inflammation in lung cancer patients with postoperative pulmonary infection.Methods:A total of 78 patients with lung cancer who received surgical treatment in our hospital between August 2013 and January 2015 and were with postoperative infection were selected as the research subjects and randomly divided into two groups, control group received mechanical ventilation therapy, observation group received bronchoalveolar lavage by bronchoscope combined with mechanical ventilation, and the inflammatory factor levels, RAAS system activity and respiratory mechanics indexes of two groups were determined after treatment.Results:3 d after treatment, serum hs-CRP, TNF-α, IL-8, PCT, renin, angiotensin II and aldosterone levels of observation group were lower than those of control group, and PIP, Raw and WOB values were lower than those of control group while Cdyn value was higher than that of control group.Conclusion:For lung cancer patients with postoperative pulmonary infection, bronchoalveolar lavage by bronchoscope combined with mechanical ventilation can optimize patients' condition, relieve systemic inflammatory response and improve respiratory function, and it has positive clinical significance.展开更多
Objective: To discuss the effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe p...Objective: To discuss the effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe pneumonia. Methods: A total of 68 patients with COPD complicated by severe pneumonia who were treated in the hospital between November 2015 and April 2017 were collected, retrospectively analyzed and then divided into the group A (n=35) who received noninvasive positive pressure ventilation and the group B (n=33) who received lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation. The differences in arterial blood gas and serum index levels were compared between the two groups before and after treatment. Results: Before treatment, there was no statistically significant difference in arterial blood gas index levels as well as serum contents of inflammatory mediators, stress hormones and myocardial enzyme spectrum indexes between the two groups. After treatment, arterial blood gas indexes PH and PaO2 levels of group B were higher than those of group A;serum inflammatory mediators HMGB1, PCT and hs-CRP contents were lower than those of group A;serum stress hormones Cor, AngⅠ and AngⅡcontents were lower than those of group A;serum myocardial enzyme spectrum indexesα-HBDH and cTn-Ⅰ contents were lower than those of group A. Conclusion: Lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation can effectively optimize the arterial blood gas levels, reduce systemic inflammatory stress state and protect the myocardial function of patients with COPD complicated by severe pneumonia.展开更多
Objective:Placement of self expanding metallic stents(SEMS) is invariably associated with complications and often necessitates their removal usually by rigid bronchoscope.There have been few reports published on use o...Objective:Placement of self expanding metallic stents(SEMS) is invariably associated with complications and often necessitates their removal usually by rigid bronchoscope.There have been few reports published on use of flexible bronchoscope(FB) for the removal.This article summarizes the indications,methods and complications of SEMS removal by FB.Methods:We reviewed our experience with removal of SEMS using FB retrospectively.The clinical data on 29 patients with average age of(39.0±13.2) years was analyzed who underwent removal of SEMS using FB between April 2002 and August 2008.Results:Thirty-seven procedures were performed in 29 consecutive patients to remove 37 stents.The average duration of stent placement was(55± 94.7) d(0-472 d).Twenty-two procedures(59.4%) were performed under local anesthesia.The percentage of procedures under general anesthesia was 13%(3/24),67%(4/6) and 100%(7/7) for the short-term(≤30 d),medium-term(31-90 d) and long-term(>90 d) of stents placement,respectively.Indications for stents removal included migration in 15(40.6%),scar restenosis in 11(29.7%),airway shaping in 5(13.5%),stent fracture in 2(5.4%),stent incomplete expansion in 2(5.4%),improper size in 1(2.7%),mucus plugging with chest pain in 1(2.7%).And 85.7% of long-term stents were removed due to scar restenosis.The total success rate was 92%.There was no significant difference in success rate between the uncovered and covered group(82.3% and 100%,P>0.05).Complications were encountered in 13 patients,bleeding being the most common(53.8%).Conclusion:Operation by FB may be an alternative method to remove SEMS effectively and safely based on the proper anesthesia chosen.展开更多
Objective In order to achieve immediate relief of central airway obstruction caused by malignant tumor after interventional therapy, we observed the efficacy and safety of cryorecanalization after cryosurgery via fle...Objective In order to achieve immediate relief of central airway obstruction caused by malignant tumor after interventional therapy, we observed the efficacy and safety of cryorecanalization after cryosurgery via flexible bronchoscope.展开更多
Objective: to study and analyze the application value of fiberoptic bronchoscopy-guided nasotracheal intubation in pre-hospital first aid. Methods: 60 pre-hospital emergency critical cases admitted in our hospital fro...Objective: to study and analyze the application value of fiberoptic bronchoscopy-guided nasotracheal intubation in pre-hospital first aid. Methods: 60 pre-hospital emergency critical cases admitted in our hospital from February 2020 to December 2021 were randomly divided into the research group and the control group with 30 cases in each group. All of them were treated with conventional pre-hospital emergency treatment. The research group was treated with nasotracheal intubation under the guidance of fiberoptic bronchoscope, while the control group was treated with open-vision endotracheal intubation. The effects of tracheal intubation and blood gas indexes before and after emergency treatment were evaluated and compared between the two groups.展开更多
Objective: to analyze the effect of bronchoscope sputum aspiration combined with alveolar lavage in the treatment of severe pulmonary infection. Methods: a total of 200 patients with severe pulmonary infection from Ap...Objective: to analyze the effect of bronchoscope sputum aspiration combined with alveolar lavage in the treatment of severe pulmonary infection. Methods: a total of 200 patients with severe pulmonary infection from April 2019 to April 2020 in our hospital were selected, and the patients were randomly divided into two groups with 100 cases in each group according to the numerical table. The patients in the control group were given conventional treatment, while those in the observation group were given additional treatment including fiberoptic bronchoscope sputum aspiration and alveolar lavage. The length of stay in hospital, medical expenses, inflammation biochemical indicators before and after treatment and the total effective rate were compared between the two groups. Results: the hospitalization days and medical expenses in the observation group were lower than those in the control group. The inflammatory biochemical test indexes of patients after treatment were lower than those in the control group. The total effective rate was higher than that in the control group (P < 0.05). Conclusion: conventional treatment combined with fiberoptic bronchoscope sputum aspiration and alveolar lavage has reliable effect on severe pulmonary infection, and can control pulmonary inflammation, shorten treatment time and reduce medical burden.展开更多
Objective To evaluate the value of autofluorescence bronchoscope (AFB) in airway examination in central type lung cancer. Methods From Sep 2009 to Mar 2010,29 patients (23 men,6 women,median age 62. 2 years,range from...Objective To evaluate the value of autofluorescence bronchoscope (AFB) in airway examination in central type lung cancer. Methods From Sep 2009 to Mar 2010,29 patients (23 men,6 women,median age 62. 2 years,range from 34 to 81 years) underwent AFB procedure. There were 3 lesions located at trachea,1 at展开更多
Objective: to explore the application value of whole-course nursing in the treatment of pneumoconiosis patients with whole lung lavage by bronchoscope. Methods: 30 patients with pneumoconiosis admitted to our hospital...Objective: to explore the application value of whole-course nursing in the treatment of pneumoconiosis patients with whole lung lavage by bronchoscope. Methods: 30 patients with pneumoconiosis admitted to our hospital from January 2017 to January 2022 were selected as the research object. According to the implementation of the nursing plan, they were divided into the whole-course group and the routine group, with 15 patients in each group. The lung function, arterial blood oxygen partial pressure index, postoperative recovery and psychological state of the two groups were compared. Results: the comparison of pulmonary function and arterial oxygen partial pressure index before treatment between the whole course group and the conventional group had statistical significance (P > 0.05). After treatment, it was better than before, and the whole course group was better than the control group (p < 0.05). Compared with the control group, the ambulation time, extubation time and hospitalization time of the whole group were lower. Compared with the conventional group, the pain score was higher (p < 0.05). Compared with the normal group, the psychological state score was higher (p < 0.05). Conclusion: during the period of treating pneumoconiosis with bronchoscope whole lung large volume lavage, complete nursing can improve the disease index of patients, accelerate the recovery of patients' symptoms, and reduce patients' negative emotions.展开更多
Fiberoptic bronchoscope （FOB） is an important instrument for respiratory, disorder examination and difficult airway can avoid management. The fiberoptic intubation the mechanical stimulus to oropharyngolaryngeal str...Fiberoptic bronchoscope （FOB） is an important instrument for respiratory, disorder examination and difficult airway can avoid management. The fiberoptic intubation the mechanical stimulus to oropharyngolaryngeal structures thereby it is likely to attenuate hemodynamic responses during orotracheal intubation. However, the relevant studies showed conflicting results. In this study, we observed the hemodynamic responses to orotracheal intubation using an FOB and a direct laryngoscope （DLS） in healthy adults under general anesthesia to examine the efficacy of the FOB in attenuating the hemodynamic responses to orotracheal intubation.展开更多
Background： There is an unmet need for a reliable method of airway randomized controlled two-center study was designed to evaluate the management for patients in the lateral position. This prospective feasibility of ...Background： There is an unmet need for a reliable method of airway randomized controlled two-center study was designed to evaluate the management for patients in the lateral position. This prospective feasibility of intubation using a flexible fiberoptic bronchoscope in the lateral position during surgery. Methods： Seventy-two patients scheduled for elective nonobstetric surgery in the lateral decubitus position requiring tracheal intubation under general anesthesia at Lishui Central Hospital of Zhejiang Province and Jiaxing First Hospital of Zhejiang Province from April I, 2015, to September 30, 2015, were enrolled in this study. Patients were randomly assigned to the supine position group （Group S, n = 38） and the lateral position group （Group L, n = 34）. Experienced anesthetists performed tracheal intubation with a fiberoptic bronchoscope after general anesthesia. The time required for intubation, intubation success rates, and hemodynamic changes was recorded. Between-group differences were assessed using the Student＇s t-test, Mann-Whitney U-test, or Chi-square test. Results： The median total time to tracheal intubation was significantly longer in Group S （140.0 [135.8, 150.0] s） compared to Group L （33.0 [24.0, 38.8] s） （P 〈 0.01）. The first-attempt intubation success rate was significantly higher in Group L （97%） compared to Group S （16%）. Hemodynamic changes immediately after intubation were more exaggerated in Group S compared to Group L （P = 0.02）. Conclusion： Endotracheal intubation with a flexible fiberoptic bronchoscope may be an effective and timesaving technique for patients in the lateral position. Trial Registration： Chinese Clinical Trial Register, ChiCTR-IIR- 16007814; http：//www.chictr.org.cn/showproj.aspx？proj= 13183.展开更多
Hemangiomas are abnormally dense collections of dilated capillary vessels which are difficult todiagnose being short of characteristic symptoms and signs. We present a patient with hemangioma who demonstrated many of ...Hemangiomas are abnormally dense collections of dilated capillary vessels which are difficult todiagnose being short of characteristic symptoms and signs. We present a patient with hemangioma who demonstrated many of the difficulties in diagnosis and led to misdiagnosis, which highlighted the importance of the modern computed tomography （CT） scan technique and bronchoscopic treatment. To our knowledge, this is thefirst report of hemangiomas with a long pedicel connected to the bronchial wall in the callan that was diagnosed and treated using bronchoscope.展开更多
Objective:To analyze the treatment effect of standardized bronchoscopic interventional therapy(i.e.,interventional therapy)on airway stenosis.Methods:Forty patients with airway stenosis admitted to the hospital betwee...Objective:To analyze the treatment effect of standardized bronchoscopic interventional therapy(i.e.,interventional therapy)on airway stenosis.Methods:Forty patients with airway stenosis admitted to the hospital between September 2022 and September 2024 were selected and randomly divided into two groups using a random number table.The experimental group received interventional therapy,while the reference group received conventional treatment.The total effective rate,degree of airway stenosis,shortness of breath score,and lung function indicators were compared.Results:The total effective rate in the experimental group was higher than that in the reference group.The proportion of mild stenosis in the degree of airway stenosis was higher in the experimental group than in the reference group.The shortness of breath score was lower in the experimental group than in the reference group.The lung function indicators were better in the experimental group than in the reference group(P<0.05).Conclusion:Interventional therapy is effective for patients with airway stenosis,as it can reduce the degree of stenosis,improve symptoms of shortness of breath,and protect patients’lung function.展开更多
Accurate and robust navigation in complex surgical environments is crucial for bronchoscopic surgeries.This study purposes a bronchoscopic lumen feature matching network(BLFM-Net)based on deep learning to address the ...Accurate and robust navigation in complex surgical environments is crucial for bronchoscopic surgeries.This study purposes a bronchoscopic lumen feature matching network(BLFM-Net)based on deep learning to address the challenges of image noise,anatomical complexity,and the stringent real-time requirements.The BLFM-Net enhances bronchoscopic image processing by integrating several functional modules.The FFA-Net preprocessing module mitigates image fogging and improves visual clarity for subsequent processing.The feature extraction module derives multi-dimensional features,such as centroids,area,and shape descriptors,from dehazed images.The Faster RCNN Object detection module detects bronchial regions of interest and generates bounding boxes to localize key areas.The feature matching module accelerates the process by combining detection boxes,extracted features,and a KD-Tree(K-Dimensional Tree)-based algorithm,ensuring efficient and accurate regional feature associations.The BLFM-Net was evaluated on 5212 bronchoscopic images,demonstrating superior performance compared to traditional and other deep learning-based image matching methods.It achieved real-time matching with an average frame time of 6 ms,with a matching accuracy of over 96%.The method remained robust under challenging conditions including frame dropping(0,5,10,20),shadowed regions,and variable lighting,maintaining accuracy of above 94%even with the frame dropping of 20.This study presents BLFM-Net,a deep learning-based matching network designed to enhance and match bronchial features in bronchoscopic images.The BLFM-Net shows improved accuracy,real-time performance,and reliability,making a valuable tool for bronchoscopic surgeries.展开更多
Objective:To observe whether wrist-ankle acupuncture can reduce propofol dosage in painless bronchoscopy of elderly patients or not and its potential effect mechanism.Methods:A total of 60 patients undergoing painless...Objective:To observe whether wrist-ankle acupuncture can reduce propofol dosage in painless bronchoscopy of elderly patients or not and its potential effect mechanism.Methods:A total of 60 patients undergoing painless bronchoscopy were randomized into a wrist-ankle acupuncture group and a control group,30 cases in each one.In the wrist-ankle acupuncture group,wrist-ankle acupuncture was received and the needles were retained for 30 min before entering to the operating room.In the control group,no any intervention was provided.The patients in two groups all received venous administration of midazolam,nalorphine and lidocaine and target controlled infusion of propofol.When the patient’s consciousness was lost and the eyelash reflex disappeared,bronchoscopy was performed and the propofol dosage was increased accordingly during operation.Propofol dosage,vital signs and occurrence of adverse reactions,bronchoscopist satisfaction,operation time and recovering time were recorded in the patients of two groups.Results:Propofol dosage in induction period and the total dosage of propofol in the wrist-ankle acupuncture group were lower than those in the control group,indicating the statistical differences(both P<0.05).The vital signs were stable during bronchoscopy in patients of two groups.The occurrence rates of hypoxemia and choking in the wrist-ankle acupuncture groups were lower than those in the control group,indicating the statistical differences(both P <0.05).Bronchoscopist satisfaction in the wrist-ankle acupuncture group was higher than that of the control group,and the operation time and recovering time were lower than the control group,indicating the statistical differences(all P<0.05).Conclusion:In painless bronchoscopy,wrist-ankle acupuncture may effectively reduce propofol dosage,alleviate respiratory suppression,reduce adverse reaction and shorten the recovering time in elderly patients.展开更多
Pneumonia caused by severe acute respiratory syndrome coronavirus 2 occasionally becomes severe and requires endotracheal intubation.Endotracheal intubation is usually performed using a laryngoscope;however,the operat...Pneumonia caused by severe acute respiratory syndrome coronavirus 2 occasionally becomes severe and requires endotracheal intubation.Endotracheal intubation is usually performed using a laryngoscope;however,the operator needs to be in close proximity to the patient’s face during the procedure,which increases the risk of droplet exposure.Therefore,we simulated fiberoptic endotracheal intubation on a mannequin representing the patient,using an ultrathin flexible gastrointestinal endoscope as an alternative to the bronchoscope,in order to maintain distance from the patient during the procedure.We performed this procedure 10 times and measured the time required;the median procedure time was 6.4 s(interquartile range,5.7-8.1 s).The advantage of this method is the short procedure time and distance maintained from the patients.The flexible tip-steerable control and length of the gastrointestinal endoscope contributed to shortening the procedure time and maintaining distance from the patients.In addition,this method can handle difficult airways without risk of misplacement of the endotracheal tube.However,it is necessary to consider the risk of aerosol generation associated with this procedure.In the pandemic setting of coronavirus disease 2019,this approach may be useful when a gastrointestinal endoscopist is in charge of endotracheal intubation of patients with coronavirus disease 2019.展开更多
Objective: To investigate the effect of mucosolvan combined with fiberoptic bronchoscopy on respiratory function, inflammatory response and stress state in patients with severe pneumonia. Methods: From January 2017 to...Objective: To investigate the effect of mucosolvan combined with fiberoptic bronchoscopy on respiratory function, inflammatory response and stress state in patients with severe pneumonia. Methods: From January 2017 to June 2018, 82 patients with severe pneumonia were randomly divided into observation group and control group (all 41 cases). Patients in the control group received conventional anti-infective treatment, and the observation group was treated with fiberoptic bronchoscopy combined with mucosolvan on the basis of the control group. Respiratory function, inflammatory response and stress status were compared between the two groups. Results: Before treatment, there was no significant difference in Cdyn, WOB and PaO2/FiO2 between the two groups. After treatment, Cdyn and PaO2/FiO2 in the observation group were (36.28±4.28) mL/cmH2O and (376.23±24.21) mmHg respectively, while those in the control group were (26.89±3.76) mL/cmH2O and (322.12±23.16) mmHg, respectively. The levels of Cdyn and PaO2/FiO2 in the observation group were higher than those in the control group. After treatment, the WOB in the observation group was (7.81±0.72) J/L, and the WOB in the control group was (8.33±1.23) J/L. WOB of both groups was lower than that before treatment, and in observation group WOB was lower than that of control group, the difference was statistically significant. In CRP, PCT and sTREM-1 levels, there was no significant difference between the two groups before treatment. After treatment, CRP, PCT and sTREM-1 in the observation group were (39.10±6.03) mg/L, (14.57±2.05) ng/L, (15.02±3.02) ng/L respectively, while those in the control group were (59.72±8.81) mg/L, (20.03±3.09) ng/L, (34.21±5.28) ng/L, respectively. CRP, PCT, sTREM-1 in both groups were lower than those before treatment, and CRP, PCT, sTREM-1 in observation group were lower than those in control group. Before treatment, there was no significant difference with Cor, Ang-I and Ang-II in two groups. After treatment, the levels of Cor, Ang-I and Ang-II in the observation group were (114.76±15.85) ng/mL, (6.72±0.64) ng/mL, (27.28±3.43) ng/mL respectively, while those in the control group were (193.15±22.64) ng/mL, (12.10±1.68) ng/mL, (43.02±5.57) ng/mL, respectively. In the observation group, the levels of Cor, Ang-I and Ang-II were lower than those in the control group. Conclusion: Mucosolvan combined with fiberoptic bronchoscopy can effectively improve the respiratory function of patients with severe pneumonia, and reduce inflammation and stress state of the body.展开更多
Objective To evaluate the diagnostic value of transbronchial lung biopsy(TBLB)via bronchoscope for lung diffuse lesions and peripheral pulmonary lesions.Methods The results of TBLB were retrospectively analyzed from 2...Objective To evaluate the diagnostic value of transbronchial lung biopsy(TBLB)via bronchoscope for lung diffuse lesions and peripheral pulmonary lesions.Methods The results of TBLB were retrospectively analyzed from 256 diagnoses of unknown patients with lung diffuse lesions or peripheral lung lesions.Results Eighty-nine final diagnosis cases via TBLB only once,the diagnostic rate of double lung diffuse lesions was the highest,[51.06%(24/47)],local non-nodule lesions,nodule lesions,cavity lesions were 33.33%(23/69),29.91%(35/117),and 28.57%(4/14),respectively.Among 24 diagnostic cases of double lung diffuse lesions,there were 6 cases of pneumonia of pulmonary tuberculosis,9 cases of lung carcinoma,7 cases of adenocarcinoma;6 cases of pneumonia,2 cases of fungous infection,and 1 case of lung hemosiderosis.The diagnostic yield about 58 cases of local lesions was low,among which non-nodule lesions accounted for 33.33% and nodule lesions accounted for 29.91%.In 89 cases of peripheral lung lesions with histological diagnosis,lung carcinoma and pulmonary tuberculosis were frequent diseases,which accounted for 86.52%.Conclusion TBLB is a reliable,safe,effective and repeatable operation method in diagnosis of lung diffuse lesions and peripheral pulmonary lesions.展开更多
BACKGROUND Takotsubo cardiomyopathy(TTC),a syndrome of acute left ventricular(LV)dysfunction,is characterized by transitory hypokinesis of LV apices with compensatory hyperkinesis of the LV basal region.The symptoms o...BACKGROUND Takotsubo cardiomyopathy(TTC),a syndrome of acute left ventricular(LV)dysfunction,is characterized by transitory hypokinesis of LV apices with compensatory hyperkinesis of the LV basal region.The symptoms of TTC mimic acute myocardial infarction,without significant coronary stenoses on coronary angiography.Echocardiogram plays a key role in the diagnosis and prognosis of TTC.New indicators from echocardiograms may be helpful in disease evaluation.CASE SUMMARY A 67-year-old man with a 10-year history of non-small cell lung cancer was admitted to our hospital for emerging facial edema and dry cough.Bronchoscopic lavage,brushing,and biopsy were performed to evaluate tumor progression.During this procedure,he complained of left chest pain,nausea,and vomiting,with elevated troponin levels.Electrocardiogram showed sinus bradycardia with ST-segment elevation in I,AVL,and V4 to V6 leads.Coronary angiography revealed mild stenosis in the right coronary artery.Echocardiography showed hypokinesis of LV apices with compensatory hyperkinesis of the LV basal region.At the 7-d follow-up,echocardiographic pressure-strain analysis showed a normal LV ejection fraction,but partial recovery of LV myocardial work,which fully recovered 5 mo later.CONCLUSION This is a case of TTC caused by bronchoscopic operation.We strongly recommend noninvasive myocardial work measured by echocardiographic pressure-strain analysis as a necessary supplementary test for the long-term follow-up of TTC.展开更多
Background and Aims： Since our rural institution has liamted resources we always choose econoamcal options. Recently, indigenous technique of pleuroscopy is gaining popularity due to various advantages. We developed ...Background and Aims： Since our rural institution has liamted resources we always choose econoamcal options. Recently, indigenous technique of pleuroscopy is gaining popularity due to various advantages. We developed indigenous technique of medical thoracoscopy has been developed and done by using set of patented conduits and fiberoptic bronchoscope （FOB）.Therefore, we have used this technique for undiagnosed pleural effusions. Methods： An observational study was conducted in 79 undiagnosed cases of exudative pleural effusion from June 2016 to Jmmary 2017. Indigenous technique consists of use of fiber optic bronchoscope through various metallic conduits to be used in specified order for medical thoracoscopy. Procedure is done under conscious sedation and conduits are passed one after another in a specified order, through the chest stoma. The visualization of pleural cavity and various procedures were done with FOB （fiberoptic bronchoscope）. Results： Out of the 79 cases, the appearance of pleura showed, inflamed/reddened pleura in 16 （20.2%） cases, thin transparent adhesions in 18 （22.7%）, thin transparent loculations in 16 （20.2%） cases, thick loculations in 6 （7.6%） cases, hard pleural surface in 5 （6.3%）, large nodule/masses in 6 （7.6%）, small amlliary seedlings or sago grain appeoxmlce in 6 （7.6%）, scattered masses or nodules in 5 （6.3%） and, broncho-pleural fistula was observed in 1 （1.2%） case. Histopathological analysis showed chronic inflammation in 34.1% （27）, tubercular lesions in 24.05% （19） of patients. Primary aspergillosis and mesothelioma each has 1 case, and the rest 29.11% （23） were pleural metastasis. Thus, diagnostic yield of pleuroscopy pleural biopsy was 89.9% （71）. Conclusion： Indigenous technique appears to be an efficient and relatively safe procedure with good diagnostic yield in undiagnosed pleural effusions.展开更多
Objective Bronchoscopy has been extensively used in the diagnosis of respiratory diseases, and par- ticularly, malignant diseases. However, endoscopists do not normally perform bronchoscopic biopsy in Case lesions are...Objective Bronchoscopy has been extensively used in the diagnosis of respiratory diseases, and par- ticularly, malignant diseases. However, endoscopists do not normally perform bronchoscopic biopsy in Case lesions are undetected via bronchoscopy. The aim of this study was to evaluate whether performing bron- choscopic biopsy could be established in the diagnosis of lung cancer in case of endobronchial abnormali- ties undetectable to the naked eye. Methods We retrospectively analyzed 109 cases between January 2008 and December 2012. The in- clusion criteria were confirmed lung cancer diagnosis, transbronchial biopsy performed in the absence of visible endobronchial manifestations, brushing, and bronchoalveolar lavage （BAL） according to the images obtained from high-resolution computed tomography （HRCT）. Data regarding age, sex, pathology, tumor stage; the method of diagnosis; location of primary lesion （central, peripheral, or intermediate）; tumor size, mediastinal lymph node metastasis, and the serum carcinoembryonic antigen （CEA） value were collected. The Pearson chi-square test or Fisher＇s exact and McNemar tests were used in the univadate analysis. Results Among the 109 patients, the diagnosis of 37 （33.9%） patients was confirmed through bronchos- copy. Brushing and BAL had higher positive detection rates than biopsy （P = 0.004）. There were no differ- ences in the positive detection rates between the sex, pathology, lesion location, tumor size, lymph node metastasis, and the serum CEA value （P〈 0.05 for all groups）. Conclusion Despite the normal appearance of the endobronchial manifestations, lesions undetectable by bronchoscopy could be indicated. Therefore, we suggest performing bronchoscopic biopsy and that brushing and BAL might increase the positive detection rate of bronchoscepic examination.展开更多
文摘Objective:To study the improving effect of sputum aspiration combined with bronchoalveolar lavage by fiber bronchoscope on the condition and inflammation in lung cancer patients with postoperative pulmonary infection.Methods:A total of 78 patients with lung cancer who received surgical treatment in our hospital between August 2013 and January 2015 and were with postoperative infection were selected as the research subjects and randomly divided into two groups, control group received mechanical ventilation therapy, observation group received bronchoalveolar lavage by bronchoscope combined with mechanical ventilation, and the inflammatory factor levels, RAAS system activity and respiratory mechanics indexes of two groups were determined after treatment.Results:3 d after treatment, serum hs-CRP, TNF-α, IL-8, PCT, renin, angiotensin II and aldosterone levels of observation group were lower than those of control group, and PIP, Raw and WOB values were lower than those of control group while Cdyn value was higher than that of control group.Conclusion:For lung cancer patients with postoperative pulmonary infection, bronchoalveolar lavage by bronchoscope combined with mechanical ventilation can optimize patients' condition, relieve systemic inflammatory response and improve respiratory function, and it has positive clinical significance.
文摘Objective: To discuss the effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe pneumonia. Methods: A total of 68 patients with COPD complicated by severe pneumonia who were treated in the hospital between November 2015 and April 2017 were collected, retrospectively analyzed and then divided into the group A (n=35) who received noninvasive positive pressure ventilation and the group B (n=33) who received lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation. The differences in arterial blood gas and serum index levels were compared between the two groups before and after treatment. Results: Before treatment, there was no statistically significant difference in arterial blood gas index levels as well as serum contents of inflammatory mediators, stress hormones and myocardial enzyme spectrum indexes between the two groups. After treatment, arterial blood gas indexes PH and PaO2 levels of group B were higher than those of group A;serum inflammatory mediators HMGB1, PCT and hs-CRP contents were lower than those of group A;serum stress hormones Cor, AngⅠ and AngⅡcontents were lower than those of group A;serum myocardial enzyme spectrum indexesα-HBDH and cTn-Ⅰ contents were lower than those of group A. Conclusion: Lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation can effectively optimize the arterial blood gas levels, reduce systemic inflammatory stress state and protect the myocardial function of patients with COPD complicated by severe pneumonia.
文摘Objective:Placement of self expanding metallic stents(SEMS) is invariably associated with complications and often necessitates their removal usually by rigid bronchoscope.There have been few reports published on use of flexible bronchoscope(FB) for the removal.This article summarizes the indications,methods and complications of SEMS removal by FB.Methods:We reviewed our experience with removal of SEMS using FB retrospectively.The clinical data on 29 patients with average age of(39.0±13.2) years was analyzed who underwent removal of SEMS using FB between April 2002 and August 2008.Results:Thirty-seven procedures were performed in 29 consecutive patients to remove 37 stents.The average duration of stent placement was(55± 94.7) d(0-472 d).Twenty-two procedures(59.4%) were performed under local anesthesia.The percentage of procedures under general anesthesia was 13%(3/24),67%(4/6) and 100%(7/7) for the short-term(≤30 d),medium-term(31-90 d) and long-term(>90 d) of stents placement,respectively.Indications for stents removal included migration in 15(40.6%),scar restenosis in 11(29.7%),airway shaping in 5(13.5%),stent fracture in 2(5.4%),stent incomplete expansion in 2(5.4%),improper size in 1(2.7%),mucus plugging with chest pain in 1(2.7%).And 85.7% of long-term stents were removed due to scar restenosis.The total success rate was 92%.There was no significant difference in success rate between the uncovered and covered group(82.3% and 100%,P>0.05).Complications were encountered in 13 patients,bleeding being the most common(53.8%).Conclusion:Operation by FB may be an alternative method to remove SEMS effectively and safely based on the proper anesthesia chosen.
文摘Objective In order to achieve immediate relief of central airway obstruction caused by malignant tumor after interventional therapy, we observed the efficacy and safety of cryorecanalization after cryosurgery via flexible bronchoscope.
文摘Objective: to study and analyze the application value of fiberoptic bronchoscopy-guided nasotracheal intubation in pre-hospital first aid. Methods: 60 pre-hospital emergency critical cases admitted in our hospital from February 2020 to December 2021 were randomly divided into the research group and the control group with 30 cases in each group. All of them were treated with conventional pre-hospital emergency treatment. The research group was treated with nasotracheal intubation under the guidance of fiberoptic bronchoscope, while the control group was treated with open-vision endotracheal intubation. The effects of tracheal intubation and blood gas indexes before and after emergency treatment were evaluated and compared between the two groups.
文摘Objective: to analyze the effect of bronchoscope sputum aspiration combined with alveolar lavage in the treatment of severe pulmonary infection. Methods: a total of 200 patients with severe pulmonary infection from April 2019 to April 2020 in our hospital were selected, and the patients were randomly divided into two groups with 100 cases in each group according to the numerical table. The patients in the control group were given conventional treatment, while those in the observation group were given additional treatment including fiberoptic bronchoscope sputum aspiration and alveolar lavage. The length of stay in hospital, medical expenses, inflammation biochemical indicators before and after treatment and the total effective rate were compared between the two groups. Results: the hospitalization days and medical expenses in the observation group were lower than those in the control group. The inflammatory biochemical test indexes of patients after treatment were lower than those in the control group. The total effective rate was higher than that in the control group (P < 0.05). Conclusion: conventional treatment combined with fiberoptic bronchoscope sputum aspiration and alveolar lavage has reliable effect on severe pulmonary infection, and can control pulmonary inflammation, shorten treatment time and reduce medical burden.
文摘Objective To evaluate the value of autofluorescence bronchoscope (AFB) in airway examination in central type lung cancer. Methods From Sep 2009 to Mar 2010,29 patients (23 men,6 women,median age 62. 2 years,range from 34 to 81 years) underwent AFB procedure. There were 3 lesions located at trachea,1 at
文摘Objective: to explore the application value of whole-course nursing in the treatment of pneumoconiosis patients with whole lung lavage by bronchoscope. Methods: 30 patients with pneumoconiosis admitted to our hospital from January 2017 to January 2022 were selected as the research object. According to the implementation of the nursing plan, they were divided into the whole-course group and the routine group, with 15 patients in each group. The lung function, arterial blood oxygen partial pressure index, postoperative recovery and psychological state of the two groups were compared. Results: the comparison of pulmonary function and arterial oxygen partial pressure index before treatment between the whole course group and the conventional group had statistical significance (P > 0.05). After treatment, it was better than before, and the whole course group was better than the control group (p < 0.05). Compared with the control group, the ambulation time, extubation time and hospitalization time of the whole group were lower. Compared with the conventional group, the pain score was higher (p < 0.05). Compared with the normal group, the psychological state score was higher (p < 0.05). Conclusion: during the period of treating pneumoconiosis with bronchoscope whole lung large volume lavage, complete nursing can improve the disease index of patients, accelerate the recovery of patients' symptoms, and reduce patients' negative emotions.
文摘Fiberoptic bronchoscope （FOB） is an important instrument for respiratory, disorder examination and difficult airway can avoid management. The fiberoptic intubation the mechanical stimulus to oropharyngolaryngeal structures thereby it is likely to attenuate hemodynamic responses during orotracheal intubation. However, the relevant studies showed conflicting results. In this study, we observed the hemodynamic responses to orotracheal intubation using an FOB and a direct laryngoscope （DLS） in healthy adults under general anesthesia to examine the efficacy of the FOB in attenuating the hemodynamic responses to orotracheal intubation.
文摘Background： There is an unmet need for a reliable method of airway randomized controlled two-center study was designed to evaluate the management for patients in the lateral position. This prospective feasibility of intubation using a flexible fiberoptic bronchoscope in the lateral position during surgery. Methods： Seventy-two patients scheduled for elective nonobstetric surgery in the lateral decubitus position requiring tracheal intubation under general anesthesia at Lishui Central Hospital of Zhejiang Province and Jiaxing First Hospital of Zhejiang Province from April I, 2015, to September 30, 2015, were enrolled in this study. Patients were randomly assigned to the supine position group （Group S, n = 38） and the lateral position group （Group L, n = 34）. Experienced anesthetists performed tracheal intubation with a fiberoptic bronchoscope after general anesthesia. The time required for intubation, intubation success rates, and hemodynamic changes was recorded. Between-group differences were assessed using the Student＇s t-test, Mann-Whitney U-test, or Chi-square test. Results： The median total time to tracheal intubation was significantly longer in Group S （140.0 [135.8, 150.0] s） compared to Group L （33.0 [24.0, 38.8] s） （P 〈 0.01）. The first-attempt intubation success rate was significantly higher in Group L （97%） compared to Group S （16%）. Hemodynamic changes immediately after intubation were more exaggerated in Group S compared to Group L （P = 0.02）. Conclusion： Endotracheal intubation with a flexible fiberoptic bronchoscope may be an effective and timesaving technique for patients in the lateral position. Trial Registration： Chinese Clinical Trial Register, ChiCTR-IIR- 16007814; http：//www.chictr.org.cn/showproj.aspx？proj= 13183.
文摘Hemangiomas are abnormally dense collections of dilated capillary vessels which are difficult todiagnose being short of characteristic symptoms and signs. We present a patient with hemangioma who demonstrated many of the difficulties in diagnosis and led to misdiagnosis, which highlighted the importance of the modern computed tomography （CT） scan technique and bronchoscopic treatment. To our knowledge, this is thefirst report of hemangiomas with a long pedicel connected to the bronchial wall in the callan that was diagnosed and treated using bronchoscope.
文摘Objective:To analyze the treatment effect of standardized bronchoscopic interventional therapy(i.e.,interventional therapy)on airway stenosis.Methods:Forty patients with airway stenosis admitted to the hospital between September 2022 and September 2024 were selected and randomly divided into two groups using a random number table.The experimental group received interventional therapy,while the reference group received conventional treatment.The total effective rate,degree of airway stenosis,shortness of breath score,and lung function indicators were compared.Results:The total effective rate in the experimental group was higher than that in the reference group.The proportion of mild stenosis in the degree of airway stenosis was higher in the experimental group than in the reference group.The shortness of breath score was lower in the experimental group than in the reference group.The lung function indicators were better in the experimental group than in the reference group(P<0.05).Conclusion:Interventional therapy is effective for patients with airway stenosis,as it can reduce the degree of stenosis,improve symptoms of shortness of breath,and protect patients’lung function.
基金funded by the National Natural Science Foundation of China(Grant No.52175028).
文摘Accurate and robust navigation in complex surgical environments is crucial for bronchoscopic surgeries.This study purposes a bronchoscopic lumen feature matching network(BLFM-Net)based on deep learning to address the challenges of image noise,anatomical complexity,and the stringent real-time requirements.The BLFM-Net enhances bronchoscopic image processing by integrating several functional modules.The FFA-Net preprocessing module mitigates image fogging and improves visual clarity for subsequent processing.The feature extraction module derives multi-dimensional features,such as centroids,area,and shape descriptors,from dehazed images.The Faster RCNN Object detection module detects bronchial regions of interest and generates bounding boxes to localize key areas.The feature matching module accelerates the process by combining detection boxes,extracted features,and a KD-Tree(K-Dimensional Tree)-based algorithm,ensuring efficient and accurate regional feature associations.The BLFM-Net was evaluated on 5212 bronchoscopic images,demonstrating superior performance compared to traditional and other deep learning-based image matching methods.It achieved real-time matching with an average frame time of 6 ms,with a matching accuracy of over 96%.The method remained robust under challenging conditions including frame dropping(0,5,10,20),shadowed regions,and variable lighting,maintaining accuracy of above 94%even with the frame dropping of 20.This study presents BLFM-Net,a deep learning-based matching network designed to enhance and match bronchial features in bronchoscopic images.The BLFM-Net shows improved accuracy,real-time performance,and reliability,making a valuable tool for bronchoscopic surgeries.
基金Supported by Scientific Research Program of Hebei Administration of Traditional Chinese Medicine:2020006。
文摘Objective:To observe whether wrist-ankle acupuncture can reduce propofol dosage in painless bronchoscopy of elderly patients or not and its potential effect mechanism.Methods:A total of 60 patients undergoing painless bronchoscopy were randomized into a wrist-ankle acupuncture group and a control group,30 cases in each one.In the wrist-ankle acupuncture group,wrist-ankle acupuncture was received and the needles were retained for 30 min before entering to the operating room.In the control group,no any intervention was provided.The patients in two groups all received venous administration of midazolam,nalorphine and lidocaine and target controlled infusion of propofol.When the patient’s consciousness was lost and the eyelash reflex disappeared,bronchoscopy was performed and the propofol dosage was increased accordingly during operation.Propofol dosage,vital signs and occurrence of adverse reactions,bronchoscopist satisfaction,operation time and recovering time were recorded in the patients of two groups.Results:Propofol dosage in induction period and the total dosage of propofol in the wrist-ankle acupuncture group were lower than those in the control group,indicating the statistical differences(both P<0.05).The vital signs were stable during bronchoscopy in patients of two groups.The occurrence rates of hypoxemia and choking in the wrist-ankle acupuncture groups were lower than those in the control group,indicating the statistical differences(both P <0.05).Bronchoscopist satisfaction in the wrist-ankle acupuncture group was higher than that of the control group,and the operation time and recovering time were lower than the control group,indicating the statistical differences(all P<0.05).Conclusion:In painless bronchoscopy,wrist-ankle acupuncture may effectively reduce propofol dosage,alleviate respiratory suppression,reduce adverse reaction and shorten the recovering time in elderly patients.
文摘Pneumonia caused by severe acute respiratory syndrome coronavirus 2 occasionally becomes severe and requires endotracheal intubation.Endotracheal intubation is usually performed using a laryngoscope;however,the operator needs to be in close proximity to the patient’s face during the procedure,which increases the risk of droplet exposure.Therefore,we simulated fiberoptic endotracheal intubation on a mannequin representing the patient,using an ultrathin flexible gastrointestinal endoscope as an alternative to the bronchoscope,in order to maintain distance from the patient during the procedure.We performed this procedure 10 times and measured the time required;the median procedure time was 6.4 s(interquartile range,5.7-8.1 s).The advantage of this method is the short procedure time and distance maintained from the patients.The flexible tip-steerable control and length of the gastrointestinal endoscope contributed to shortening the procedure time and maintaining distance from the patients.In addition,this method can handle difficult airways without risk of misplacement of the endotracheal tube.However,it is necessary to consider the risk of aerosol generation associated with this procedure.In the pandemic setting of coronavirus disease 2019,this approach may be useful when a gastrointestinal endoscopist is in charge of endotracheal intubation of patients with coronavirus disease 2019.
文摘Objective: To investigate the effect of mucosolvan combined with fiberoptic bronchoscopy on respiratory function, inflammatory response and stress state in patients with severe pneumonia. Methods: From January 2017 to June 2018, 82 patients with severe pneumonia were randomly divided into observation group and control group (all 41 cases). Patients in the control group received conventional anti-infective treatment, and the observation group was treated with fiberoptic bronchoscopy combined with mucosolvan on the basis of the control group. Respiratory function, inflammatory response and stress status were compared between the two groups. Results: Before treatment, there was no significant difference in Cdyn, WOB and PaO2/FiO2 between the two groups. After treatment, Cdyn and PaO2/FiO2 in the observation group were (36.28±4.28) mL/cmH2O and (376.23±24.21) mmHg respectively, while those in the control group were (26.89±3.76) mL/cmH2O and (322.12±23.16) mmHg, respectively. The levels of Cdyn and PaO2/FiO2 in the observation group were higher than those in the control group. After treatment, the WOB in the observation group was (7.81±0.72) J/L, and the WOB in the control group was (8.33±1.23) J/L. WOB of both groups was lower than that before treatment, and in observation group WOB was lower than that of control group, the difference was statistically significant. In CRP, PCT and sTREM-1 levels, there was no significant difference between the two groups before treatment. After treatment, CRP, PCT and sTREM-1 in the observation group were (39.10±6.03) mg/L, (14.57±2.05) ng/L, (15.02±3.02) ng/L respectively, while those in the control group were (59.72±8.81) mg/L, (20.03±3.09) ng/L, (34.21±5.28) ng/L, respectively. CRP, PCT, sTREM-1 in both groups were lower than those before treatment, and CRP, PCT, sTREM-1 in observation group were lower than those in control group. Before treatment, there was no significant difference with Cor, Ang-I and Ang-II in two groups. After treatment, the levels of Cor, Ang-I and Ang-II in the observation group were (114.76±15.85) ng/mL, (6.72±0.64) ng/mL, (27.28±3.43) ng/mL respectively, while those in the control group were (193.15±22.64) ng/mL, (12.10±1.68) ng/mL, (43.02±5.57) ng/mL, respectively. In the observation group, the levels of Cor, Ang-I and Ang-II were lower than those in the control group. Conclusion: Mucosolvan combined with fiberoptic bronchoscopy can effectively improve the respiratory function of patients with severe pneumonia, and reduce inflammation and stress state of the body.
文摘Objective To evaluate the diagnostic value of transbronchial lung biopsy(TBLB)via bronchoscope for lung diffuse lesions and peripheral pulmonary lesions.Methods The results of TBLB were retrospectively analyzed from 256 diagnoses of unknown patients with lung diffuse lesions or peripheral lung lesions.Results Eighty-nine final diagnosis cases via TBLB only once,the diagnostic rate of double lung diffuse lesions was the highest,[51.06%(24/47)],local non-nodule lesions,nodule lesions,cavity lesions were 33.33%(23/69),29.91%(35/117),and 28.57%(4/14),respectively.Among 24 diagnostic cases of double lung diffuse lesions,there were 6 cases of pneumonia of pulmonary tuberculosis,9 cases of lung carcinoma,7 cases of adenocarcinoma;6 cases of pneumonia,2 cases of fungous infection,and 1 case of lung hemosiderosis.The diagnostic yield about 58 cases of local lesions was low,among which non-nodule lesions accounted for 33.33% and nodule lesions accounted for 29.91%.In 89 cases of peripheral lung lesions with histological diagnosis,lung carcinoma and pulmonary tuberculosis were frequent diseases,which accounted for 86.52%.Conclusion TBLB is a reliable,safe,effective and repeatable operation method in diagnosis of lung diffuse lesions and peripheral pulmonary lesions.
文摘BACKGROUND Takotsubo cardiomyopathy(TTC),a syndrome of acute left ventricular(LV)dysfunction,is characterized by transitory hypokinesis of LV apices with compensatory hyperkinesis of the LV basal region.The symptoms of TTC mimic acute myocardial infarction,without significant coronary stenoses on coronary angiography.Echocardiogram plays a key role in the diagnosis and prognosis of TTC.New indicators from echocardiograms may be helpful in disease evaluation.CASE SUMMARY A 67-year-old man with a 10-year history of non-small cell lung cancer was admitted to our hospital for emerging facial edema and dry cough.Bronchoscopic lavage,brushing,and biopsy were performed to evaluate tumor progression.During this procedure,he complained of left chest pain,nausea,and vomiting,with elevated troponin levels.Electrocardiogram showed sinus bradycardia with ST-segment elevation in I,AVL,and V4 to V6 leads.Coronary angiography revealed mild stenosis in the right coronary artery.Echocardiography showed hypokinesis of LV apices with compensatory hyperkinesis of the LV basal region.At the 7-d follow-up,echocardiographic pressure-strain analysis showed a normal LV ejection fraction,but partial recovery of LV myocardial work,which fully recovered 5 mo later.CONCLUSION This is a case of TTC caused by bronchoscopic operation.We strongly recommend noninvasive myocardial work measured by echocardiographic pressure-strain analysis as a necessary supplementary test for the long-term follow-up of TTC.
文摘Background and Aims： Since our rural institution has liamted resources we always choose econoamcal options. Recently, indigenous technique of pleuroscopy is gaining popularity due to various advantages. We developed indigenous technique of medical thoracoscopy has been developed and done by using set of patented conduits and fiberoptic bronchoscope （FOB）.Therefore, we have used this technique for undiagnosed pleural effusions. Methods： An observational study was conducted in 79 undiagnosed cases of exudative pleural effusion from June 2016 to Jmmary 2017. Indigenous technique consists of use of fiber optic bronchoscope through various metallic conduits to be used in specified order for medical thoracoscopy. Procedure is done under conscious sedation and conduits are passed one after another in a specified order, through the chest stoma. The visualization of pleural cavity and various procedures were done with FOB （fiberoptic bronchoscope）. Results： Out of the 79 cases, the appearance of pleura showed, inflamed/reddened pleura in 16 （20.2%） cases, thin transparent adhesions in 18 （22.7%）, thin transparent loculations in 16 （20.2%） cases, thick loculations in 6 （7.6%） cases, hard pleural surface in 5 （6.3%）, large nodule/masses in 6 （7.6%）, small amlliary seedlings or sago grain appeoxmlce in 6 （7.6%）, scattered masses or nodules in 5 （6.3%） and, broncho-pleural fistula was observed in 1 （1.2%） case. Histopathological analysis showed chronic inflammation in 34.1% （27）, tubercular lesions in 24.05% （19） of patients. Primary aspergillosis and mesothelioma each has 1 case, and the rest 29.11% （23） were pleural metastasis. Thus, diagnostic yield of pleuroscopy pleural biopsy was 89.9% （71）. Conclusion： Indigenous technique appears to be an efficient and relatively safe procedure with good diagnostic yield in undiagnosed pleural effusions.
文摘Objective Bronchoscopy has been extensively used in the diagnosis of respiratory diseases, and par- ticularly, malignant diseases. However, endoscopists do not normally perform bronchoscopic biopsy in Case lesions are undetected via bronchoscopy. The aim of this study was to evaluate whether performing bron- choscopic biopsy could be established in the diagnosis of lung cancer in case of endobronchial abnormali- ties undetectable to the naked eye. Methods We retrospectively analyzed 109 cases between January 2008 and December 2012. The in- clusion criteria were confirmed lung cancer diagnosis, transbronchial biopsy performed in the absence of visible endobronchial manifestations, brushing, and bronchoalveolar lavage （BAL） according to the images obtained from high-resolution computed tomography （HRCT）. Data regarding age, sex, pathology, tumor stage; the method of diagnosis; location of primary lesion （central, peripheral, or intermediate）; tumor size, mediastinal lymph node metastasis, and the serum carcinoembryonic antigen （CEA） value were collected. The Pearson chi-square test or Fisher＇s exact and McNemar tests were used in the univadate analysis. Results Among the 109 patients, the diagnosis of 37 （33.9%） patients was confirmed through bronchos- copy. Brushing and BAL had higher positive detection rates than biopsy （P = 0.004）. There were no differ- ences in the positive detection rates between the sex, pathology, lesion location, tumor size, lymph node metastasis, and the serum CEA value （P〈 0.05 for all groups）. Conclusion Despite the normal appearance of the endobronchial manifestations, lesions undetectable by bronchoscopy could be indicated. Therefore, we suggest performing bronchoscopic biopsy and that brushing and BAL might increase the positive detection rate of bronchoscepic examination.
