Journal of Bronchology & Interventional Pulmonology最新文献

{"title":"Diffuse Pulmonary Meningotheliomatosis in a Patient With Neurodermatitis With Prurigo Nodularis.","authors":"Jeremy Kim, David T Cooke, Elham Kamangar, Hanine Inaty","doi":"10.1097/LBR.0000000000000902","DOIUrl":"10.1097/LBR.0000000000000902","url":null,"abstract":"","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":" ","pages":"379-381"},"PeriodicalIF":3.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33469890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resolution of Airway Lesions in Recurrent Respiratory Laryngeal Papillomatosis With Radiation Therapy.","authors":"Ankush P Ratwani, Robert J Lentz, Sally J York, Fabien Maldonado, Evan C Osmundson, Otis B Rickman","doi":"10.1097/LBR.0000000000000876","DOIUrl":"10.1097/LBR.0000000000000876","url":null,"abstract":"","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"30 3","pages":"290-293"},"PeriodicalIF":3.3,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9808866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Restenosis Following Bronchoscopic Airway Stenting for Complex Tracheal Stenosis.","authors":"Ara A Chrissian,&nbsp;Javier Diaz-Mendoza,&nbsp;Michael J Simoff","doi":"10.1097/LBR.0000000000000878","DOIUrl":"10.1097/LBR.0000000000000878","url":null,"abstract":"<p><strong>Background: </strong>Nonsurgical patients with complex postintubation tracheal stenosis (PITS) and tracheostomy-associated tracheal stenosis (PTTS) often require airway stenting. However, the optimal approach is unknown. Identifying patients at higher risk for restenosis after stent removal may allow the treating physician to individualize the vigilance and duration of airway stenting, and help optimize outcomes.</p><p><strong>Methods: </strong>This was a single-center retrospective analysis of prospectively collected data on all patients with complex PITS and/or PTTS treated with protocolized bronchoscopic airway stenting over a consecutive 16-year period. The primary outcome analyzed was restenosis rate at 1 year after stent removal. Predictors for restenosis and factors influencing risk for death during stent therapy were also assessed.</p><p><strong>Results: </strong>Of the 181 subjects treated with silicone airway stenting, 128 were available for analysis of the primary outcome. Restenosis by 1 year after stent removal occurred in 58%. Independent predictors for restenosis were coexisting diabetes [odd ratio (OR)=3.10, 95% confidence interval (CI)=1.04-9.24; P =0.04], morbid obesity (OR=3.13, 95% CI=1.20-8.17; P =0.02), and occurrence of stent-associated complications requiring bronchoscopic management (OR=2.13, 95% CI=1.12-4.03; P =0.02). The overall mortality during the initial stenting period was 14%, and a silicone Y-stent was associated with a higher risk of death (OR=3.58, 95% CI=1.40-9.14; P =0.008).</p><p><strong>Conclusion: </strong>Tracheal restenosis after silicone stent therapy for complex PITS and PTTS is common and more likely to occur in patients with diabetes, morbid obesity, and frequent stent-associated complications. Mortality risk during stent therapy is not negligible, and a Y-stent should be utilized only after careful consideration. These findings may be incorporated into the approach to bronchoscopic airway stenting in these patients.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"30 3","pages":"268-276"},"PeriodicalIF":3.3,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10100599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endobronchial Valve Placement as Salvage Therapy in the Management of Hemoptysis.","authors":"John W Frey,&nbsp;Maykol Postigo,&nbsp;Lucas R Pitts","doi":"10.1097/LBR.0000000000000898","DOIUrl":"10.1097/LBR.0000000000000898","url":null,"abstract":"","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"30 3","pages":"301-303"},"PeriodicalIF":3.3,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10129556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracheobronchial Amyloid Subglottic Stenosis Treatment Using Low-temperature Radio frequency Therapy.","authors":"Noah Kosnik,&nbsp;Marlee Colligan,&nbsp;Michael Neuenschwander","doi":"10.1097/LBR.0000000000000893","DOIUrl":"10.1097/LBR.0000000000000893","url":null,"abstract":"iodine.7,8 In the modern era, intrapleural antiseptics are not used due to an expanded armamentarium of antibiotics and improved surgical techniques. A small, randomized control trial did demonstrate improved pleural evacuation with normal saline irrigation when used in addition to standard management.9 In this challenging case, it is possible that the inability to fully evacuate his pleural space despite standard medical management contributed to increasing antibiotic resistance. We felt it was imperative to achieve source control to manage his sepsis. As he was not a candidate for surgical evacuation, we opted to use Dakin’s Solution when multiple courses of tPA/ DNase failed. It is unclear whether the empyema would have resolved with escalation of antibiotics alone. His empyema, however, recurred despite 2 rounds of appropriate antibiotics, thoracostomy tube drainage, and intrapleural fibrinolytics.He achieved resolution of his empyema after irrigation with Dakin’s Solution which suggests it may have played a role in his improvement. Notably, he tolerated the procedure well without any serious complications. Intrapleural antiseptics may be considered in patients with medically refractory empyema who are not surgical candidates.","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"30 3","pages":"298-301"},"PeriodicalIF":3.3,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9743377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrapleural Dakin's Solution for Refractory Empyema in a Critically Ill Patient.","authors":"Soibhan R Kelley,&nbsp;Abraham Scott McCall,&nbsp;Edward T Qian,&nbsp;Eugene Wesley Ely","doi":"10.1097/LBR.0000000000000886","DOIUrl":"10.1097/LBR.0000000000000886","url":null,"abstract":"Middle mediastinal lesions: imaging findings and pathologic correlation. Eur J Radiol. 2000;35:30–38. 5. Crapo JD, Glassroth J, Karlinsky J, et al. Baum’s Textbook of Pulmonary Diseases. Philadelphia, PA: Lippincott Williams & Wilkins; 2004:883–912. 6. Vilmann P, Clementsen PF, Colella S, et al. Combined endobronchial and oesophageal endosonography for the diagnosis and staging of lung cancer. European Society of Gastrointestinal Endoscopy (ESGE) guideline, in cooperation with the European Respiratory Society (ERS) and the European Society of Thoracic Surgeons (ESTS). Eur Respir J. 2015;46:40–60. 7. De Waele M, Carp L, Lauwers P, et al. Paravertebral schwannoma with high uptake of fluorodeoxyglucose on positron emission tomography. Acta Chir Belg. 2005; 105:537–538. 8. Navani N, Nankivell M, Lawrence DR, et al. Lung cancer diagnosis and staging with endobronchial ultrasound-guided transbronchial needle aspiration compared with conventional approaches: an openlabel, pragmatic, randomized controlled trial. Lancet Respir Med. 2015;3:282–289.","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"30 3","pages":"296-298"},"PeriodicalIF":3.3,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9749564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Simulator for Teaching Endobronchial Ultrasound-guided Needle Biopsy.","authors":"Yousef Ahmad,&nbsp;Luke Domaleski,&nbsp;Michael Hellmann,&nbsp;Patrick Kosciuk,&nbsp;Christopher Radchenko,&nbsp;Arjan Flora,&nbsp;Roman Jandarov","doi":"10.1097/LBR.0000000000000873","DOIUrl":"10.1097/LBR.0000000000000873","url":null,"abstract":"<p><strong>Background: </strong>Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has become standard for the diagnosis of lung cancer, and there is an increasing need for procedural competence in trainees. We evaluate a low-cost, gelatin-based EBUS-TBNA training simulator to assess pulmonary fellows' baseline skills and facilitate procedural development.</p><p><strong>Methods: </strong>A low-cost ($30) gelatin-based, high-fidelity simulator was created to represent the airways, major vessels, and lymph node stations essential to identify for EBUS-TBNA. Trainees had a baseline skills assessment using the simulator and were then provided a 1-hour didactic session on EBUS-TBNA and additional practice time with the simulator. Trainees then underwent a postsimulation skills assessment using a modified endobronchial ultrasound (EBUS)-Skills and Tasks Assessment Tool (STAT) performance assessment tool. Simulator fidelity and trainee procedural confidence was assessed using a 10-point scale.</p><p><strong>Results: </strong>Ten fellows received training on the EBUS-TBNA simulator. First-year trainees scored the lowest on the 18-point performance scale with a mean score of 9, while third-year trainees scored highest with a mean score of 17.5. Mean 18-point performance score improvement after simulator training and didactics was 4.31 points for all trainees with the largest change in first-year trainees amounting to 8.25 points. First-year trainees experienced the greatest improvement in EBUS procedural confidence by a mean of 2.5 points on a 10-point confidence survey.</p><p><strong>Conclusion: </strong>A low-cost EBUS simulator effectively differentiated early and advanced learners based on graded procedural performance scores. Simulation-based practice significantly improved learners' procedural performance, and the degree of improvement correlated with learner inexperience. The simulation significantly increased early learner confidence in EBUS-TBNA technique.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"30 3","pages":"252-257"},"PeriodicalIF":3.3,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9741497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In the Pursuit to Develop a Meaningful Scoring System for EDAC.","authors":"Nakul Ravikumar,&nbsp;Septimiu Murgu","doi":"10.1097/LBR.0000000000000928","DOIUrl":"https://doi.org/10.1097/LBR.0000000000000928","url":null,"abstract":"","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"30 3","pages":"197-199"},"PeriodicalIF":3.3,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9757659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Five Versus 10 Pharyngeal Sprays of 10% Lignocaine for Topical Anesthesia During Flexible Bronchoscopy: A Multicenter, Randomized Controlled Trial.","authors":"Hariharan Iyer,&nbsp;Mayank Mishra,&nbsp;Girish Sindhwani,&nbsp;Saurabh Mittal,&nbsp;Pawan Tiwari,&nbsp;Vijay Hadda,&nbsp;Anant Mohan,&nbsp;Randeep Guleria,&nbsp;Karan Madan","doi":"10.1097/LBR.0000000000000869","DOIUrl":"10.1097/LBR.0000000000000869","url":null,"abstract":"<p><strong>Background: </strong>Ensuring adequate patient comfort is crucial during bronchoscopy. Although lidocaine spray is recommended for topical pharyngeal anesthesia, the optimum dose of sprays is unclear. We compared 5 versus 10 sprays of 10% lidocaine for topical anesthesia during bronchoscopy.</p><p><strong>Methods: </strong>In this investigator-initiated, prospective, multicenter, randomized clinical trial, subjects were randomized to receive 5 (group A) or 10 sprays (group B) of 10% lidocaine. The primary objective was to compare the operator-rated overall procedure satisfaction between the groups.</p><p><strong>Results: </strong>Two hundred eighty-four subjects were randomized (143 group A and 141 group B). The operator-rated overall procedure satisfaction, VAS [mean (SD)] was similar between the groups [group A, 74.1 (19.9) and group B, 74.3 (18.5), P =0.93]. The VAS scores of patient-rated cough [group A, 32.5 (22.9) and group B, 32.3 (22.2), P =0.93], and operator-rated cough [group A, 29.8 (22.3) and group B, 26.9 (21.5), P =0.26] were also similar. The time to reach vocal cords, overall procedure duration, mean doses of sedatives, the proportion of subjects willing to return for a repeat procedure (if required), and complications were not significantly different. Subjects in group A received significantly less cumulative lidocaine (mg) [group A, 293.9 (11.6) and group B, 343.5 (10.6), P <0.001].</p><p><strong>Conclusion: </strong>During bronchoscopy, topical anesthesia with 5 sprays of 10% lidocaine is preferred as it is associated with a similar operator-rated overall procedure satisfaction at a lower cumulative lidocaine dose compared with 10 sprays.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"30 3","pages":"232-237"},"PeriodicalIF":3.3,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9796434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prognostic Predictors of Airway Stenting in Malignant Airway Involvement From Esophageal Carcinoma.","authors":"Nophol Leelayuwatanakul,&nbsp;Vorawut Thanthitaweewat,&nbsp;Virissorn Wongsrichanalai,&nbsp;Chawalit Lertbutsayanukul,&nbsp;Anussara Prayongrat,&nbsp;Sarin Kitpanit,&nbsp;Thitiwat Sriprasart","doi":"10.1097/LBR.0000000000000879","DOIUrl":"10.1097/LBR.0000000000000879","url":null,"abstract":"<p><strong>Background: </strong>In locoregional esophageal carcinoma (EC), airway involvement is the most common route of extraesophageal metastasis. The prognosis remains poor even with a multimodality approach. Although airway stenting is well known for restoration of the airway, the survival benefit is still lacking.</p><p><strong>Methods: </strong>A total of 37 of patients with airway involvement from EC who underwent airway stenting at a single institution from 2015 to 2020 were retrospectively reviewed. Survival curves after stent placement among different groups were analyzed using Kaplan-Meier method.</p><p><strong>Results: </strong>Of 37 patients, 34 were male, and the mean age was 58.9 years (42 to 80). EC was commonly located at midesophagus (51.4%). The site of airway involvement was left main bronchus (48.6%), trachea (32.4%), multiple sites (16.2%), and right main bronchus (2.7%). The nature of airway involvement was tumor invasion (91.9%), compression (62.2%), and fistula (37.8%). Twenty-three patients (62.2%) had airway involvement at the time of esophageal cancer diagnosis. Only 4 patients underwent esophageal stenting. The median survival time after stent placement was 97 days (5 to 539). Chemotherapy and/or radiotherapy were given before stent placement in 18 patients (48.6%). Treatment-naive before airway stenting and diagnosis of airway involvement at the same time of EC diagnosis were independent predictors for the increased survival after stent placement ( P <0.05). Poststent treatment was associated with improved survival ( P =0.002).</p><p><strong>Conclusion: </strong>In patients with malignant airway involvement from EC who underwent airway stenting, the prognostic predictors for improved survival were treatment-naive status, receiving treatment after airway stenting, and early-onset of airway involvement.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"30 3","pages":"277-284"},"PeriodicalIF":3.3,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7c/3b/lbr-30-277.PMC10312900.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9796888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}