This is an automatically translated article.
Bronchoscopy biopsy is a new technique in Vietnam. While thoracoscopy and mediastinoscopy must be performed in the operating room with complicated procedures, bronchoscopy with biopsy can be performed in the common bronchoscopy room, helping to assess the damage at the same time. and nearby organs, have performed biopsies to take samples for testing quickly, efficiently and safely.
1. Overview of bronchoscopy biopsies
Bronchoscopy biopsy is a technique that uses an endoscope inserted into the body through the trachea and bronchi to observe the inner surface of the bronchi and take samples for necessary histopathological tests.
Lung cancer is a condition in which malignant tumors in the lungs arise from the cells, epithelium, bronchi, bronchioles, alveoli or from the bronchial glands. This type is different from cancers that have metastasized from other places such as stomach, colon, liver... (secondary cancer). Primary lung cancer is divided into 2 types:
Non-small cell lung cancer (85%): with bronchial adenocarcinoma accounting for 70%. Small cell lung cancer (15%).
2. The role of bronchoscopy biopsy
Observe anatomical lesions inside the bronchi; Taking samples for diagnosis: Determining the cause, differentiating and prognostication of the disease (cancer staging); Diagnosis of malignancies such as: lung malignancy, tracheobronchial cancer, esophageal cancer; Monitor results of bronchial cancer treatment; Observe the state of movement of the respiratory mucosa, vocal cords, detect and evaluate lesions in the trachea, bronchi (biopsy if necessary); Bronchoscopy can also wash the bronchi, aspirate fluid, and sputum to perform cytological and microbiological tests.
Nội soi phế quản sinh thiết là một kỹ thuật mới ở Việt Nam
3. Indications and contraindications
To perform a successful bronchoscopic biopsy technique, there are a few indications that need to be noted. There are patients who respond and do not respond to treatment, so during the initial examination and screening process, it is necessary to classify these two groups.
3.1. Indications Endoscopic bronchial biopsy is usually indicated in the following cases:
Diagnosis of bronchial cancer, trachea, lung malignancy; Detecting benign tumors in the airways, assessing the extent of tumor growth; Diagnosing respiratory infections: bronchitis, pneumonia, lung abscesses, containing a lot of purulent fluid in the respiratory tract... Follow up after lung surgery, support the treatment of tracheal and lung cancers manage. Need to find the cause of the condition: hemoptysis, prolonged cough, pneumothorax or pleural effusion, hoarseness, tracheal stenosis... Locate and monitor lesions after acute tracheostomy rescue or intubation ... 3.2. Contraindications Bronchoscopy is contraindicated in the following cases:
Patients with heart failure, arrhythmia, myocardial infarction, recent or unstable angina, condition uncontrolled hypertension... Patients with severe respiratory failure, uncontrolled bronchial asthma, undrained pneumothorax, alveolar dilatation with many large air cysts... There is a coagulopathy. Patient is not cooperative.
Nguyên tắc nội soi sinh thiết phế quản là nên soi bên lành lặn trước để tránh lây nhiễm bệnh sang bên phổi lành
4. Note when bronchoscopy biopsy
The principle of bronchoscopic biopsy is to examine the healthy side first to avoid spreading the disease to the healthy lung. Specimens need to biopsies about 4-6 pieces of brush sticks used for cytological examination.
However, when performing the bronchoscopy biopsy technique, the patient may also encounter some complications or risks such as:
Allergic to local anesthetic, so it is often necessary to assess the ability to adapt to the drug. anesthetize the patient before performing endoscopy; There is a risk of damage to the bronchial mucosa during the movement of the bronchoscope; Bleeding at the lung biopsy site; Risk of infection, atelectasis, pneumothorax (rarely, only about 5-5.5%) In summary, bronchoscopy is an important technique in the diagnosis of lung lesions. respiratory tract injury. However, patients should carefully learn about the indications and non-indications and consult their doctor before performing this procedure. Currently, Vinmec International General Hospital is one of the leading prestigious hospitals in the country, trusted by a large number of patients for medical examination and treatment. Not only the physical system, modern equipment: 6 ultrasound rooms, 4 DR X-ray rooms (1 full-axis machine, 1 light machine, 1 general machine and 1 mammography machine) , 2 DR portable X-ray machines, 2 multi-row CT scanner rooms (1 128 rows and 1 16 arrays), 2 Magnetic resonance imaging rooms (1 3 Tesla and 1 1.5 Tesla), 1 room for 2 levels of interventional angiography and 1 room to measure bone mineral density.... Vinmec is also the place to gather a team of experienced doctors and nurses who will greatly assist in diagnosis and detection. early signs of abnormality in the patient's body. In particular, with a space designed according to 5-star hotel standards, Vinmec ensures to bring the patient the most comfort, friendliness and peace of mind.
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