Author/Editor		Kecelj, Peter
Title		Bronhoskopija in zamejitev pljučnega raka
Translated title		Bronchoscopy and staging of lung cancer
Type		članek
Source		Endoskopska revija
Vol. and No.		Letnik 7, št. 18
Publication year		2002
Volume		str. 36-9
Language		slo
Abstract		Staging of lung cancer can be divided into local staging and searching for the distant metastasis. Local spread of lung cancer in central airways and definitive diagnosis are made by means of bronchoscopy. The distension of proposed lung resection by bronchoscopist and performed lung resection by thoracic surgeon were analysed in 158 patients in a retrospective study. Both diagnoses were identical in 71% of the cases, larger extents of resection were necessary in 26% and smaller extents of resection were needed in 3.2% of the patients. The main reason for larger resections was the extension of lung cancer to the adjacent structures, not reached by bronchoscopy. The mediastinoscopy is not necessary when the staging of the mediastinal lymph nodes is made by means of transbronchial needle aspiration (TBNA). We analysed 50 patients with lung cancer in a retrospective study. In 20% of them, the involvement of mediastinal lymph nodes was diagnosed by TBNA.
Summary		Zamejitev pljučnega raka obsega lokalno oceno razširjenosti bolezni in iskanje oddaljenih zasevkov. Bronhoskopija omogoča postavitev dokončne diagnoze, oceno lokalne razširjenosti pljučnega raka in obseg operativnega posega. Z uporabo avtoflourescence lahko ugotovimo tumorsko spremenjeno sluznico, ki je v običajni svetlobi ne vidimo. Pri 158 bolnikih s pljučnim rakom je bil pri 71% bolnikov izveden enak obseg operacije, kot je bil priporočen ob bronhoskopiji, pri 3% manjši poseg in pri 26% večji poseg. Vraščanje v sosednje strukture, ki jih endoskopsko nismo mogli ugotoviti, je bil največkrat vzrok za večji poseg. Zaseženost bezgavk mediastinuma lahko dokažemo z bronhoskopsko igelno aspiracijo (BIA), s čimer bolnikom prihranimo mediastinoskopijo. Pri 50 bolnikih s pljučnim rakom smo v retrospektivni analizi ugotovili zaseženost teh bezgavk v 20%. Pri tako razširjeni bolezni (N2) smo bolnike zdravili le s kemoterapijo in obsevanjem. Endobronhialni ultrazvok (EBUS) omogoči ugotovitev natančne namestitve povečanih bezgavk pred BIA. Bronhoskopija je nujna diagnostična metoda v zamejitvi pljučnega raka.
Descriptors		LUNG NEOPLASMS BRONCHOSCOPY NEOPLASM SEEDING LYMPHATIC METASTASIS MEDIASTINUM