Broncoscopia de intervenção

ABSTRACTBronchoscopy became over the last fifteen years a mainstream in the diagnostic investigation, treatment and follow up of the patients with respiratory diseases. The advances in technology make the procedures more easy and tolerable by patients. The safety of the local and general anesthesia, became more and more generalized the use of this diagnostic and (much more) therapeutical mean. Furthermore the traditional indications of bronchoscopy, mainly the fiberoptic bron-choscotpy has been performed more and more frequently in intensive care units on managing respiratory insuficient patients dealing with the treatment of atelectasis and with diagnostic of respiratory infections. The diagnosis of respiratory infections in imunocompromised a very frequent indication to performe fiberoptic bronchoscopy, manly in neutropenic and in acquired imunodeticient syndrome patients. In this work we intend to give an extended view about the indications, execution thechnics, results and complications of bronchoscopy in the treatment of the diseases involving the tracheo-bronchial tract We include the therapeutical methodology of accidentaly inhaled foreign bodies extraction, manly in children, the correction of benign tracheal stenosis and the treatment of tracheo-bronchial neoplasic obstructions. Lung cancer given their growing pathern frequently involve trachea, bronchis and the neighboring tissues causing ventilatory difficulties. This situation needs many times local treatment that must be integrated in the global lung cancer treatment strategy. We describe various therapeutical modalities including instrumental desobstrucsing with rigid bronchoscope, thermical means to destructing the tumour (cryotherapy, electrocautery, laser), brachitherapy and stents insertion.We conclude, as the lung cancer is the main cause of tracheo-bronchial obstruction, local therapy must be integrated with global lung cancer management in order to improve life quality and quantity