Bronchoscopy for the diagnosis and treatment of respiratory diseases

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Posted by Resident Doctor, Master Tran Duc Tuan - Department of Diagnostic Imaging - Vinmec Central Park International General Hospital
In order to reduce the impact as well as dangerous complications caused by respiratory diseases, timely diagnosis and treatment is extremely important. Currently, bronchoscopy is considered to be the most accurate and modern diagnostic method, which plays an important role in early diagnosis and treatment of respiratory diseases.

1. Bronchoscopy with diagnostic techniques used

Flexible bronchoscopy with white light Even with video bronchoscopy (video bronchoscopy), although it has low sensitivity, it can provide good visualization of the central airways.
Autofluorescence bronchoscopy (AFB) Better detection of pre-invasive endobronchial lesions.
High-magnification bronchoscopy To magnify the bronchial wall 100-110 times, using a combination of bronchoscope and video bronchoscope for the purpose of clearly seeing the bronchial mucosal microvasculature helps detect dysplasia or cancer at an early stage if many blood vessels are concentrated.
Narrow band imaging (NBI) Instead of using wideband (Red/Green/Blue) in standard video bronchoscopy, this approach helps to visualize the submucosal vascular network. Endoscopy with narrow frequency imaging helps to detect angiogenesis, the abnormally twisted vascular network of the carcinogenesis process.
Optical coherence tomography (OCT) Instead of using ultrasound, this technique gives high resolution subsurface structures like ultrasound but uses light near infrared through the test channel. Cell and extracellular images were acquired by this method through scattering analysis with spatial resolution from 3-15 m and 2mm depth to provide quasi histological images in the bronchial wall. .

2. Bronchoscopy for diagnosis and treatment of respiratory diseases

Currently, flexible bronchoscopy is considered the most modern, fastest and most accurate method of diagnosis and intervention for respiratory diseases.
Perform flexible bronchoscopy only when there is suspicion of pathology in the airways, lungs, or abnormalities in the lymph nodes in the chest. Doctors will use this technique to treat diseases in certain circumstances, such as aspiration caused by a foreign body.
Bronchoscopy helps the doctor to observe the respiratory tract with a flexible endoscope to diagnose diseases in the bronchial tree, from the trachea to the small bronchi by bronchoscopy. The lesions in the trachea and bronchi are detected through this method. In addition, bronchoscopy also helps doctors take samples out of the bronchial walls, in the lung parenchyma, to access the lesions near the edge of the lung.
In order to perform soft bronchoscopy, minimizing the risk of injury to the patient, requires the performing doctor to have expertise and high skill because this is a difficult technique. Below are some respiratory diseases diagnosed by bronchoscopy, including:
Suspected patient has bronchopulmonary cancer, mediastinal tumor There is a foreign body in the airway Patient has inflammation Chronic, recurrent pulmonary disease Patient has unexplained shortness of breath Patient coughs up blood, cough persists for more than 2 weeks Cases of collapsed lung The cause of pleural effusion is unknown. diagnosis of infectious diseases, respiratory infections, pulmonary fungi... Abnormal points on chest X-ray but not diagnosed by other methods Suspect that the patient has a tracheal fistula or tracheal perforation. Patients with hoarseness Before removing the tracheostomy, the glottis should be assessed first. Currently, by performing bronchoscopy, doctors can diagnose lung cancer early even in situ (stage 0) ) even pre-invasive dysplastic lesions. Besides, more and more effective means of treatment such as electrocautery, laser... are applied, helping to improve the patient's life and quality of life.

In addition to diagnosis, bronchoscopy also has the effect of treating a number of respiratory diseases, such as:
Removal of foreign bodies in the airways Hemostasis Treatment of airway tumors by electrocautery/laser sputum obstruction or blood clot causing atelectasis Treatment of hoarseness by granulation or polypectomy of the vocal cords Bronchoscopy is a technique that can help accurately diagnose respiratory diseases, especially cancer bronchi. The early diagnosis of the patient's condition helps the doctor to offer effective and timely treatment methods for the patient.
At Vinmec International General Hospital, flexible bronchoscopy is performed on modern machinery, this technique does not make patients uncomfortable when conducting endoscopy: Choking, feeling Asphyxiation... Before the procedure, the patient will be anesthetized and carefully controlled the airway to ensure safety and minimize irritation or discomfort for the patient, then the doctor will perform perform endoscopic techniques, remove foreign bodies and then check and control to ensure there are no complications for the patient.
For consultation and registration for bronchoscopy with anesthesia at Vinmec International Hospital, please book an appointment on the website for service.

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