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Brave new world for interventional bronchoscopy
  1. T P Toma1,
  2. D M Geddes2,
  3. P L Shah3
  1. 1National Heart and Lung Institute, Dovehouse Street, London SW3 6JY, UK
  2. 2Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK
  3. 3Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK and the Chelsea & Westminster Hospital, London SW10 9NH, UK
  1. Correspondence to:
    Dr P L Shah
    Department of Respiratory Medicine, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK; pallav.shahimperial.ac.uk

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New applications for interventional bronchoscopy

Until recently, interventional bronchoscopy was limited to foreign body removal, debulking endobronchial tumours, or insertion of stents for the palliation of lung cancer. Most of these procedures are performed with a rigid bronchoscope under general anaesthesia by thoracic surgeons. As a result, only a few respiratory physicians developed an interest in interventional bronchoscopy. The small range of interventions has meant that, up to now, interventional bronchoscopy has been less glamorous than, for example, interventional cardiology.

Will this situation change? Firstly, there is an increased interest in transbronchial fine needle aspiration (TBNA) for staging lung cancer and in endobronchial ultrasound guided TBNA.1 The latter technique samples suspicious lymph nodes as small as 5 mm and has the potential for replacing mediastinoscopy. Secondly, tumours can be debulked with electrocautery, photodynamic therapy or lasers, and stents can be inserted under local anaesthesia with flexible bronchoscopes.

Recent research has driven an expansion of interventional bronchoscopy for some of the more common non-malignant respiratory diseases. Bronchial thermoplasty for the treatment …

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