Author/Editor		Triller, Nadja
Title		Diagnostični postopki pri perifernih pljučnih tumorjih
Translated title		Diagnostic procedures in peripheral pulmonary tumours
Type		članek
Source		Endoskopska revija
Vol. and No.		Letnik 7, št. 18
Publication year		2002
Volume		str. 29-35
Language		slo
Abstract		Bronchoscopic and percutaneous approaches to peripheral pulmonary lesions are effective and safe diagnostic procedures. To establish the diagnosis either one of the available methods is chosen, or both are integrated in a logical sequence of diagnostic procedures. The paper deals with the folowing two examinations: 1. Bronchoscopy: exploration of the bronchial tree, bronchoscopic lung biopsy-BLB, transbronchial needle aspiration - TBNA, bronchial and/or bronchoalveolar lavage-BAL. 2. Percutaneous fine needle aspiration (PCNA) under fluroscopic, computer tomography (CT) or ultrasound (US) guidance. The second part of the paper presents a retrospective analysis of 115 patients with measurable peripheral pulmonary tumours without endobronchial lesions diagnosed in 2001. They were divided into two groups: those with lesions <-3 cm and those with lesions of >3cm. The patients underwent bronchoscopy with BLB, TBNA, bronchial brushing or fluoroscopy, CT-or US-guided BAL and PCNA when the bronchoscopy was not diagnostic. Only three (3%) of these patients were diagnosed surgically. In 81 patients (70%), the final diagnosis was established by bronchoscopy (lesions<-3 cm, 61%, lesions >3 cm, 79%) In 34 patients, in whom bronchoscopy was not dignostic, diagnosis was established by PCNA (lesions<-3 cm, 91%, lesions>3cm, 92%). Apart from PCNA-related pneumothorax in 4 cases (12%), no serious complications were observed.
Summary		Bronhoskopska ali transtorakalna diagnostika perifernih pljučnih sprememb sta učinkoviti in varni diagnostični metodi, ki sta lahko alternativni ali pa ju opravimo zaporedno. V prispevku predstavljamo obe preiskavi. 1. Bronhoskopija: pregled centralnih dihalnih poti in bronhoskopska igelna aspiracija (BIA), bronhoskopska pljučna biopsija (BPB), krtačenje bronhijev (KB) in/ali bronhoalveolni izpirek (BAI). 2. Transtorakalna tankoigelna biopsija (TTIB) pod nadzorom rentgena, računalniške tomografije (CT) ali ultrazvoka. V nadaljevanju predstavljamo retrospektivno analizo 115 bolnikov z merljivimi, perifernimi pljučnimi tumorji in normalnimi bronhoskopskimi izvidi, ki smo jih obravnavali v naši ustanovi leta 2001. Razdelili smo jih v dve skupini: s spremembami, večjimi od 3 cm, in s spremembami, manjšimi od 3 cm. Bolnike smo bronhoskopirali in opravili BPB, BIA, KB in/ali BAI. Če z bronhoskopijo nismo ugotovili bolezen, smo opravili TTIB. Tri bolnike (3%) smo napotili na kirurško diagnostiko. Celotna občutljivost bronhoskopije v diagnostiki perifernih pljučnih tumorjev je bila 70%, pri spremembah, večjih od 3 cm, je bila 79% in pri manjših od 3 cm 61%. TTIB smo opravili pri 34 bolnikih, pri spremembah, večjih od 3 cm, je bila občutljivost 92%, pri spremembah, manjših od 3 cm, pa 91%. Resnejših zapletov ob posegih nismo zabeležili. Po TTIB smo pri 12% (4 od 34) bolnikov opazili pnevmotoraks.
Descriptors		LUNG NEOPLASMS BRONCHOSCOPY BIOPSY, NEEDLE BRONCHOALVEOLAR LAVAGE