Journal of bronchology & interventional pulmonology
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J Bronchology Interv Pulmonol · Jan 2014
Case ReportsClosure of chronic bronchopleural fistula using atrial septal occluder device.
Chronic persistent bronchopleural fistulae (BPF) are challenging management problems. The management of BPF includes various surgical and medical procedures and of great value is the use of bronchoscopy and different devices. In high-risk surgical patients, bronchoscopic procedures serve as a temporary bridge until the patient's clinical condition improves, whereas in other patients bronchoscopic procedures may be the only option. We present a case of postoperative chronic BPF closed by a less invasive interventional bronchoscopic procedure using an atrial septal occluder device.
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J Bronchology Interv Pulmonol · Jan 2014
Endobronchial ultrasound-guided biopsy performed under optimal conditions in patients with known or suspected lung cancer may render mediastinoscopy unnecessary.
Mediastinoscopy is the gold standard for preoperative mediastinal staging of patients with suspected or proven lung cancer. Since the development of endoscopic ultrasound-guided biopsy via the trachea (EBUS-TBNA), this status has been challenged. The purpose of the study was to examine whether mediastinoscopy is necessary, when EBUS-TBNA is performed in a center with (1) a high level of expertise, (2) "bed side" microscopy by a pathologist, (3) general anesthesia, and (4) achievement of representative tissue from station 4R, 7 and 4L, that is, the same mediastinal stations that mediastinoscopy gives access to. ⋯ When EBUS-TBNA is performed under optimal conditions including general anesthesia and "bed side" microscopy performed by a pathologist resulting in representative biopsies from station 4R, 7, and 4L, the NPV is so high that mediastinoscopy seems unnecessary.
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J Bronchology Interv Pulmonol · Oct 2013
Transforming growth factor-β1 rise in pleural fluid after tunneled pleural catheter placement: pilot study.
Transforming growth factor-β1 (TGF-β1) plays a major role in pleural fibrosis and chemical pleurodesis. Approximately 50% of patients with tunneled pleural catheters (TPCs) for malignant pleural effusions (MPEs) will have autopleurodesis. Pleural TGF-β1 levels have never been measured in the setting of TPC drainage and may predict autopleurodesis. ⋯ TPC insertion results in an independent increase in TGF-β1 levels in MPE.
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J Bronchology Interv Pulmonol · Oct 2013
Review Case ReportsMediastinal abscess after endobronchial ultrasound-guided transbronchial needle aspiration: a case report and literature review.
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive technique that allows lung cancer nodal staging and biopsy of parabronchial and paratracheal tissue. Its simplicity, high diagnostic yield, ability to diagnose both benign and malignant conditions, and exceedingly low complication rate has resulted in rapid widespread adoption by surgeons and physicians. EBUS-TBNA-related complications, however, do occur and need to be considered when assessing the risk-benefit profile of performing the procedure, and if the patient represents with unexpected symptoms after the procedure. ⋯ This case demonstrates the importance of considering EBUS-TBNA-related complications to guide relevant imaging decisions and antibiotic choices. We review the published literature regarding infective complications of EBUS-TBNA and propose possible pathophysiologies. These complications are likely to increase in frequency as the technique is more widely adopted.