BRONCHOLOGY: RESEARCH, DIAGNOSTIC AND THERAPEUTIC ASPECTS DEVELOPMENTS IN SURGERY VOLUME 3 Other titles in this series 1. J .M. Greep, H.A.J. Lemmens, D.B. Roos, H.C. Urschel, eds., Pain in Shoulder and Arm: An Integrated View. ISBN 90-247-2146-6 2. B. Niederle, Surgery of Gall Ducts. ISBN 90-247-2402-3 Series: ISBN 90-247-2350-7 BRONCHOL0 GY: RESEARCH, DIAGNOSTIC, AND THERAPEUTIC ASPECTS Proceedings of the Second World Congress for Bronchology, held at Dusseldorf, FRG, 2-4 June 1980 edited by JOHN A. NAKHOSTEEN, MD Chest Physician, Consultant Bronchologist, Ruhrlandklinik, Essen, FRG and WERNER MAASSEN, MD Professor of Medicine, Medical Director, Ruhrlandklinik, Essem, FRG President, 2nd World Congress for Bronchology 1981 MARTINUS NIJHOFF PUBLISHERS THE HAGUE / BOSTON / LONDON Distributors for the United States and Canada Kluwer Boston, Inc. 190 Old Derby Street Hingham, MA 02043 USA for all other countries Kluwer Academic Publishers Group Distribution Center P.O.Box 322 3300 AH Dordrecht The Netherlands This volume is listed in the Library of Congress Cataloging in Publication Data ISBN -13 :978-94-009-8238-3 e-ISBN -13: 978-94-009-8236-9 001: 10.1007/978-94-009-8236-9 Copyright @ 1981 by Martinus Nijhoff Publishers bv, The Hague. Soflcover reprint of the hardcover 1st edition 1981 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher. Martinus Nijhoff Publishers bv, P.O.Box 566, 2501 CN The Hague, The Netherlands ACKNOWLEDGEMENTS We would like to express our gratitude to the many colleagues and co-workers who helped make the Second World Congress for Bronchology 50 successful. Our particular thanks go to the members of the Organizing, Finance, Scientific and Planing Committees. The Technical and Office Staff, which included students, secretaries and other hospital personnel was indispensable in seeing that thousand-and-one details were fulfilled. For the special contribution that each of the follol'/ing gave, we would like to mention by name Dr. and j-irs. ','. Petro, Dr. -:. Dams, i-;r. i-I. Leiendecker, Miss I. Angerstein and cando med. D. Leimenstoll. To Dr. S. Ikeda and the staff of the World Association for 8ronchology Head Office in Tokyo we also owe a special thanks for their organizing the far eastern parti cipation and their giving valuable advice. Generous financial support by Olympus Optical Company, Hamburg and Tokyo, had enabled us to purchase a limited number of copies of BRONCHOLOGY 1980 at a reduced rate and pass this saving on to congress participants placing firm pre-publication orders with uSi I.e would like to thank Olympus for this help. i'lr. Jeffrey Smith of l'Iartinus i'.jijhoff has readily given valuable advice every time we have had to turn to him, and we appreciate this greatly. Finally, our unending thanks go to our wives, who, each in her own way, patiently and actively supported us in over two years of work for the Congress and for this book. I,:. j-,aassen Essen, F .r~.G. tlUgust, 19t1O TABLE OF CONTENTS Chapter I. INTRODUCTION J A Nakhosteen, W Maassen Chapter II. EARLY DIAGNOSIS BRONCHOGENIC CARCINO~~ 11 11.1. Diagnosis of Early Lung Cancer H A Andersen 13 11.2. Screening for Lung Cancer R S Fontana, D R Sanderson, W F Taylor, M A Uhlenhopp 15 11.3. Friedel's Catheter Biopsy in Peripheral Lung Cancer (in German) ¥\ !:!etzer 18 II.4. Early Diagnosis of Peripheral Bronchogenic Carcinoma by Cytological Examination of Catheter Biopsies R \';orch, R Hammesfahr, Z Atay 21 11.5. Comparative Study between the Macroscopic Pathological Findings and Difficulties in Detection of the Sites of Early Stage Lung Cancer R Ono, S Ikeda 29 11.6. Fluorescent Bronchoscopy: A New Technique and Furthe~ Results D Hurzeler 33 II.7. The Reliability of Cytodiagnosis in Determining tlalig nancy and Histogenetic Tumour Type Z Atay 37 II.B. Sputum-cytologic Diagnosis of Early Roentgenologically Occult Bronchogenic Carcinoma S Hoglund, J Kinnman, K Nasiell, M Nasiell, L Malm- strom, V Roger 43 II.9.The Diagnosis of Precancerous Lesions and ~~ltifocal Carcino~a of the Bronchial Epithelium with Fiberoptic Bronchoscopy F Klinke, H Dittrich, R Achatzy, K M MUller, E Anyanwu, V Jelesijevic 47 II.10.Bronchofiberscopic Observations on Bronchial Epithelium of Heavy Smoker H 1wahashi, K Hagiwara, M Nogawa 51 VIII II.ll.Fiberoptic Bronchoscopic Findings in Cases of Atypical Squamous Metaplasia N Hayashi, K Oho, R Amemiya, T Kawauchi, K Nagai, K Hayakawa, I Iimura, Y Hayata 53 II.l2.Vascular Patterns Observed via the Fiberoptic Bronche scope in Cases of Lung Cancer R Amemiya, K Oho, MAida, N Hayashi, K Nagai, N Takizawa, Y Hayata 57 II.l3.Early Detection of Hilar Type of Bronchogenic Carcinoma H Mikami, Y Ohsaki, S Abe, K Kimura, I Tsuneta, M Murao 59 II. l4.Tumorous Diseases of Trachea and Bronchi Giving no X-ray Shadow E Banhidi 61 II.15.Electronmicroscopic Study of Lung Cancer Specimen Biopsied by Large Channel Bronchofiberscope T Kawai, T Ogata, K Kikuchi, K Watanabe 65 II.16.Forceps-Biopsy Material - A Sample for Histologic and Cytologic Examination M Roglic 69 II. l7.Diagnostic Flexible Fiberoptic Bronchoscopy: Analysis of Results of Biopsy and Brush in 105 Patients Y C Hsieh, C H Chiang, C Y Shen, C C Yang 72 II.18.A Multimodal Diagnostic Approach to Lung Cancer S Horie, K Shimada, K Matsumura, Y Seki 75 II. 19.5ome Aspects of Research \'lork on Chronic Bronchitis in China x Z Weng, H G Qiu 78 Chapter III. BRONCHOSCOPY AND INTENSIVE CARE t1EDICINE 81 III. 1.Bronchial Suctioning with the Flexible Bronchoscope B G OIlman, C-E Lindholm, U Nordin 83 III.2.Therapeutic Bronchoscopy in the Operating Room and the Recovery Room 85 J Tamada, M Aoki, Y Shimizu, M Ito, R Teramatsu III.3.Transbronchial Lung Biopsy for Differential Diagnosis of Acute Pulmonary Failure G Goeckenjan, Th KHnigshausen, W ElsBsser, A Schmidt-GrBff 87 IX III.4.Diagnostic and Therapeutic Value of the Fiberoptic Bronchoscopic Procedures in the Intensive Care Unit and the Recovery Room T Kahi, S Hanawa 90 III.5.A Case of Severe Airway Burn Successfully Treated with the Fiberoptic Bronchoscope K Oho, I Iimura, N Kawate 95 III.6.Bronchoskopie-Intubation R Schindl, K Aigner, J \~Urz 97 Chapter IV. COMPLICATIONS IN BRONCHOLOGICAL INVESTIGATIONS 99 IV.l.Complications in Bronchological Investigations using a Bronchofiberscope: Results of 9,413 Procedures H C Ko, R P Perng, Y C Hsieh, W CHuang, K T Luh 101 IV.2.Prevalence and Treatment of Complications of 550 Fiberbronchoscopies E Hershko, N Reichert, G L Baum 104 IV.3.Complications Following Fiberoptic Bronchoscopy A Koyama, H Anno 107 IV.4.A I'Jew Method for Treatment of Bronchial and Lung Bleeding H Schlehe, H-1'1 Fritsche, S Daum 111 IV.5.Complications Following Flexible Bronchofiberscope - Prevention and Treatment of Endobronchial Bleeding after Biopsy 1'1 Kaneko, J Honda, K Sohma, T Takahashi, N Yamamoto, H Yoshimura, T Matsubayashi, R Ono, S Ikeda 113 IV.6.A Safety Position in Bronchofiberscopy J F Dumon 115 IV.7.A New Double Lumen Endotracheal Tube for Fiberoptic Bronchoscopy H f<ronenberger, K-H Nerger, h Ru st, t'l Schneider 117 IV.o.Oro-Tracheal Intubation using the Double Lumen Tube J H Harrell II, R G Spragg, K i,'i i·loser 121 IV.9.Cardiac Arrest as a Complication of 8ronchological InvestigCltion N Anti6 124 IV.l0.ICoroioc khythm Disturbol1C05 duriW. ::'1:'onciloscopy Ii,. 'schaefer, 'j RCiU~:,ch 127 x IV.ll.Cardiac Complications and Changes of Arterial 3100d Gas Levels During Transbronchoscopic Lung Siopsy t·l Fukuoka, S Tarnai, M Takada, N Okunaka, N Sakai 130 IV. 12.Bloodless 502 Monitaring to Prevent Complications in 8ronchofiberoptic Procedures J M G de Vega, A Merida, J Morales, F Gonzalez, J Gutierrez 133 IV.13.Hypoxer:1ia During Flexible Fiberbronchoscopy J Roux, ~.: Hartmann 135 IV. 14.Some Aspects of Complications on Transbronchicl Lung Biopsy II I<urashima, H i<omatsu, 1<, Ishihara. R Yoneda, T Haga 137 IV. 15.Topicol ~nesthe5ia in a Large Number of Flexible 3ronchoscopies J Atocha 139 IV.16.Hemodynamic Effects in Bronchoscopy during Ventila tion 3ronchoscopy and Sanders Venturi Ventilation W Wrabetz, W Hartmann 141 IV. l7.Intravenous Anaesthesia Techniques as an Alternative to Halothane Anaesthesia in Bronchoscopic Procedures V Schulz, K Stosseck 143 Chapter V. BRONCHOGRAPHY IN THE DIAGNOSIS OF LUNG DISEASE 145 V. l.Bronchography in Pulmonary Diseases K Watanabe, S Ikeda 147 V. 2.Course of Bronchography from 1959 to 1979 in a Department of Chest Disease 151 J Engel V. 3.Significance of Peripheral Bronchography on Coin Lesion R Ono, S Ikeda 153 V. 4.Tracheobronchial Tuberculosis Diagnosed by Broncho scopy and Bronchography T Kurasawa, F Kuze, M Nakanishi, N ~laekawa, K Oida, T Iwata, Y Oda 156 V. 5.Clinical Examination of Bronchial Tuberculosis as Distinguished from Lung Cancer ASato, K Yoshimura 158 V. 6.Possibilities for Bronchography Using the Broncho fiberscope (in German) R G Reimann 160 XI V. 7.Selective Bronchography and Transbronchial Biopsy E ~1atsui, H i-liyake, S Yanagawa, [.j Shibayama, H Doi 162 V. B.A New Technique of Bronchography and its Clinical Application Reury-P Perng. Chao-T Hsing 165 V. 9.Usefulness of Bronchography - with Special Emphasis on Delineation of f'jucosal Changes of the Large Bronchus K Kimura, Y Ohsaki, S Abe, Y Tsuneta, H r-:ikami, ~1 Muraa 167 Chapter VI. SARCOIDOSIS 171 VI. 1.Broncho-Alveolar Lavage (SAL) in 120 Patients with Sarcoidosis: Cellular Data and Relation with Serum Angiotensin Converting Enzyme (SACE) A Arnoux, G Stanislas-Leguern, C Danel, J Marsac, G Huchon, C Fabre, R Dufat, J Chretien 173 VI. 2.The Validation and Use of KVEIM Test Suspensions D N ~. . itchell, J R Mikhail, M i~ McNicol, J V Collins, D M Mitchell, M W Dighero 176 VI. 3.Results of Different Biopsies in Sarcoidosis (Mediastinoscopy, DANIELS' Biopsy, Bronchial and Lung Biopsies) D Greschuchna, W Maassen, Chr. Malchau 179 VI. 4.A Comparison of Fiberoptic Transbronchial Lung Biopsy (TBB) with Other Techniques in the Diagnosis of Sarcoidosis D M Mitchell, D N Mitchell, C J Emerson, J V Collins 184 VI. 5.TBLB as a Diagnostic Procedure for Sarcoidosis in Japan - A Cooperative Study in Twenty-four Hospitals K Honda, M Kado, T Izumi, T Osaki, Y Hiraga, K Iwai, R Yoneda, M Washizaki, H Homma, J Kabe, H Osada, H Okano, T Furuie, H Hosoda, Y Ito, K Hirasawa, I Mo chizuki, ASato, Y Yamamoto, R Amitani, R Mikami, N Kurihara, T Tachibana, S Hitomi, N Ochi, F Kitatani, J Nakai, M Yamakido, K Shima, S Miyagi 186 VI. 6.Transbronchial Lung Biopsy in Sarcoidosis L-G Wiman, Y Hornblad 189 VI. 7.Bronchoscopy in the Diagnosis of Sarcoidosis M Thunell, R Lundgren, N Stjernberg . 193