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Objective To evaluate the value of the electron bronchoscopy in diagnosis of carcinothoracic fluid in the case of replacing medical thoracoscopy and combining narrow-band imaging (NBI). Methods 89 cases of suspected cancerous pleural effusion patients, used electronic bronchoscope Olympus BF-1T 260 in place of medical thoracoscopy to enter pleural cavity in the usual way. First observed by white light bronchoscopy (WLB), then by narrow-band imaging (NBI) and take 5 pieces of tissue out respectively on the pleura of the lesion for pathological examination. Then compare the sensitivity and specificity of WLB and NBI methods, and the bleeding after biopsy. Result Among 89 cases of suspected cancerous pleural effusion patients, 85 cases found positive by white light bronchoscopy (WLB) , negative in 4 cases, 6 cases bleeding after biopsy (6.70%). Compared with the pathological results, WLB sensitivity 97.50%, specificity 22.22%. 68 cases found positive by NBI, negative 21 cases, no active bleeding after biopsy. Compared with the pathological results, the sensitivity of the NBI 86.67%, specificity 78.57%. Compared WLB with NBI, the former's sensitivity is superior to the latter, the latter's specificity is superior to the former. Both comparisons about sensitivity diagnosis of the and specificity are statistically significant (P < 0.05). Conclusion Electronic bronchial in place of medical thoracoscopy has high diagnostic rate in the carcinothoracic fluid, and the combination of NBI can improve the accuracy and security of the biopsy.
RESUMO
BACKGROUND: With the advances of video technology, thoracoscopic surgery has been applied to various areas of the thoracic surgical fields including major surgeries. Now a days, thoracoscopic surgery is performed as a procedure of choice for primary spontaneous pneumothorax. But the operative indication for the primary spontaneous pneumothorax has not been changed since the last few decades, although the procedure of choice was changed from open thoracotomy to thoracoscopy. Therefore, we thought new treatment strategy will be necessary for the management of primary spontaneous pneumothorax. MATERIAL AND METHOD: Between January 1998 and December 1999, 149 primary spontaneous pneumothorax patients were admitted to the Kyungpook National University Hospital. Result; Of these patients, 177 were first attack pneumothoraces and the number of total attacks were 250. CONCLUSION: Analyzing the amount of pneumothorax, methods of treatment, number of recurrences, recurrence rate and hospital stay, we propose a critical pathway for establishing new treatment strategy for the management of primary spontaneous pneumothorax.