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Analysis of the bronchoscopic manifestations and treatment of broncholithiasis

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Author:
No author available
Journal Title:
Chinese Journal of Lung Diseases (Electronic Edition)
Issue:
3
DOI:
10.3877/cma.j.issn.1674-6902.2024.03.014
Key Word:
支气管结石;气管镜;气道狭窄;治疗;预后

Abstract: Objective:To investigate the bronchoscopy manifestations and treatment of patients with broncholithiasis.Methods:The bronchoscopy manifestations, treatment methods and complications of 5 patients with broncholithiasis that completely removed by bronchoscopy admitted to Tangdu Hospital of Air Force Military Medical University from January 2019 to July 2021 were retrospectively analyzed. Among the 5 patients, 1 case was male and 4 cases were female; 1 case was complicated with lung cancer after operation, 1 case was complicated with pulmonary tuberculosis and bronchial tuberculosis, and 3 cases had no other disease. The location of broncholithiasis: 2 cases of left main bronchus, 1 case of left upper lobe, 1 case of apical segment of right upper lobe, and 1 case of basal segment of right lower lobe. Bronchoscopy findings of broncholithiasis were white or gray-blackc hard caseous necrotic stone, associated with lumen stenosis or blockage at the lesion site, and 3 cases were associated with granulation tissue hyperplasia around the lesion. Treatment methods: 1 case of holmium laser combined with biopsy forceps, 1 case of holmium laser, biopsy forceps, foreign body mesh basket and freezing in 1 case, 1 case of freezing, foreign body forceps, 1 case of crocodile jaw forceps, 1 case of biopsy forceps.Results:The lesions of 5 patients were completely removed and the lumen was recanalized. 3 patients had a small amount of bleeding, and the bleeding was stopped by spraying ice-salt-grade hemostatic drugs under the microscope. 1 patient with moderate bleeding was sprayed with hemostatic drugs under the microscope, and vasopressin was given intravenously to stop the bleeding. There were no other complications like heart failure, malignant arrhythmia, and pneumothorax.Conclusion:Bronchoscopy is an important method for the treatment of broncholithiasis. Most of the broncholithiasis that are easily exposed, loosened and can be decomposition by holmium laser can be completely removed by bronchoscopy, and should be performed in an endoscopy center with rich clinical experience.

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