Normal and Pathological Bronchial Semiology: A Visual Approach
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About this ebook
Normal and Pathological Bronchial Semiology: A Visual Approach provides normal endobronchial aspects, including variations, anomalies and abnormal findings. Comprehensive coverage includes preoperative airway assessment in lung surgeries, airways after surgery, including complications, process and management, and airway complications in lung transplantation patients. It is a full reference that is perfect for pulmonary researchers, chest physicians, bronchoscopists, pulmonologists and cardiothoracic surgeons.
- Features complete coverage of all aspects of normal and pathological bronchial semiology
- Includes more than 250 photos with short descriptions
- Includes 100 bronchoscopy videos covering all different topics discussed in the book
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Normal and Pathological Bronchial Semiology - Pierre Philippe Baldeyrou
Normal and Pathological Bronchial Semiology
A Visual Approach
Edited by
Pierre Baldeyrou
Interventional Bronchoscopy Unit, Division of Thoracic Surgery and Lung Transplantation, Marie Lannelongue Hospital, Paris, France
Amir Hanna
Interventional Bronchoscopy Unit, Division of Thoracic Surgery and Lung Transplantation, Marie Lannelongue Hospital, Paris, France
Adrian Crutu
Interventional Bronchoscopy Unit, Division of Thoracic Surgery and Lung Transplantation, Marie Lannelongue Hospital, Paris, France
Table of Contents
Instructions for Accessing Video Content
Cover image
Title page
Copyright
List of Contributors
Biography
Foreword
Preface
Acknowledgment
Abbreviations
Part I: Plan
Chapter 1. Fiber-Optic Bronchoscopy
Abstract
A Fiber-Optic Bronchoscopy Examination
B Local Anesthesia
C Samples Collection
Chapter 2. Normal Trachea and Bronchi
Abstract
A Normal Trachea
B Normal Bronchi
C Bronchial Secretions and Secreting Glands
D Anatomic Variants
E Description and International Nomenclature
Cases
Chapter 3. Pathological Semiology
Abstract
A Trachea
B Bronchi
C Fluorescence, Carcinomas In Situ
Cases
Chapter 4. Tumors
Abstract
A Benign Tumors
B Attenuated Malignant and Malignant Tumors
C Malignant Tumors After Thoracic Radiation
Cases
Chapter 5. Tuberculosis
Abstract
A Progressive Pulmonary Tuberculosis
B Stenotic Scarring and Calcification-Related Diseases
Cases
Chapter 6. Infectious and Inflammatory Pathologies
Abstract
A Pathological and Microbial Aspects
B Bronchoscopic Aspects
Cases
Chapter 7. Tracheobronchial Tree Dynamics
Abstract
A Normal Dynamics, Rigidity, and Bronchospasm
B Dynamic Collapse or Hypotonia
Cases
Chapter 8. Nontumor-Related Tracheobronchial Stenosis
Abstract
A Tracheal Stenosis
B Bronchial Stenosis
Cases
Chapter 9. Bronchoscopy in Intensive Care and Anesthesia
Abstract
A During Anesthesia
B Intensive Care and Resuscitation
C Special Cases of Bronchial Molds
Cases
Chapter 10. Bronchi After Thoracic Surgery and Radiation
Abstract
A Bronchial Scars
B Dehiscence and Fistulae
C Bronchial Axis Deviation
D After Radiation Therapy
Cases
Chapter 11. Bronchi After Lung Transplantation
Abstract
A Lesions
B Chronology
C Bronchoscopic Procedures
Cases
Chapter 12. Hemoptysis
Abstract
A Diagnostic Bronchoscopy
B Bronchoscopy Induced Hemoptysis
Cases
Chapter 13. Foreign Body
Abstract
Cases
Chapter 14. Stent Monitoring and Care
Abstract
Cases
Chapter 15. The Art Of Description
Abstract
Conclusion
Appendices
Appendix 1. Topography and International Nomenclature
Appendix 2. Bronchial Complications After Lung Transplantation: Dutau’s MDS Classification
Appendix 3. ISHLT Adult and Pediatric Airway Complications After Lung Transplant: Proposed Grading System
Ischemia and Necrosis (I)
Dehiscence (D)
Stenosis (S)
Malacia (M)
Appendix 4. Bronchoscopy Videos and Manuscript
Chapter 2: Normal Trachea and Bronchi
Chapter 3: Pathological Semiology
Chapter 4: Tumors
Chapter 6: Infectious and Inflammatory Pathologies:
Chapter 8: Non–Tumor-Related Tracheobronchial Stenosis:
Chapter 10: Bronchi After Thoracic Surgery and Radiation:
Chapter 11: After Lung Transplantation:
Chapter 12: Hemoptysis
Chapter 13: Foreign body
Chapter 14: Stent Monitoring and Care
Further Reading
Anatomical Pathology
ENT
Bronchial Endoscopy in General
Interventional Endoscopy
Electromagnetic Scanning
Tracheal Stenoses
Bronchi and Lung Transplantation
Hemoptyses
Postoperative Deformations
Index
Copyright
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Notices
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ISBN: 978-0-12-815795-4
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List of Contributors
Pierre Baldeyrou, Interventional Bronchoscopy Unit, Division of Thoracic Surgery and Lung Transplantation, Marie Lannelongue Hospital, Paris, France
pierrebaldeyrou@yahoo.fr
Amir Hanna, Interventional Bronchoscopy Unit, Division of Thoracic Surgery and Lung Transplantation, Marie Lannelongue Hospital, Paris, France
amirkmaurice@gmail.com
Adrian Crutu, Interventional Bronchoscopy Unit, Division of Thoracic Surgery and Lung Transplantation, Marie Lannelongue Hospital, Paris, France
nacrutu@yahoo.com
M.R. Ghigna, Department of Pathology, Marie Lannelongue Hospital, Paris, France
mr.ghigna@hml.fr
Biography
Dr. Baldeyrou
Dr. Pierre Baldeyrou
Pierre Baldeyrou was born in 1949. He completed his medical studies in Amiens and then Paris. In 1972 he specialized in Pulmonology and Bronchial Endoscopy. He learned the rigid bronchoscopy techniques from Dr. J.M. Lemoine in Clamart and Créteil, and from Dr. Oustrières at Tenon Hospital between 1973 and 1975. In 1975, he started a very long collaboration with the department of Prof. Pariente in Clamart and later at Beaujon and Bichat Hospitals (subsequently with his successors, Prof. Fournier and Prof. Mal). In late 1975, he joined the Department of thoracic Surgery of Prof. J. Aigueperse and Prof. G. Lemoine of CMC (Medical Surgical Center) in Porte de Choisy. In 1980, he became a consultant in Pulmonology and interventional bronchoscopy at Gustave Roussy Oncology Institute in Villejuif.
Later, he continued his collaboration in thoracic surgery with Dr. Bisson, followed by a professional growth at Marie Lannelongue hospital with Prof. Dartevelle and Prof. Fadel.
His publications and collaborations focused on pulmonology, thoracic surgery, diagnostic and interventional bronchoscopy, endobronchial ultrasound, endobronchial brachytherapy, and treatments of lung cancer. Throughout his professional life, he taught young pulmonologists the various endoscopic techniques and the bases of bronchial semiology; this work is the result of experience accumulated of more than 40 years of reflection and practice.
Dr. Amir Hanna
Doctor Hanna graduated in 2010 from the Faculty of Medicine of Cairo University with a Bachelor Degree in Medicine. He completed his master’s degree in Pulmonary Medicine from Faculty of Medicine, Cairo University, to join the Chest Department at Dar Al Fouad Hospital of Egypt in collaboration with Cleveland Clinic of the United States.
In 2015 he moved to Paris to join the Cardiothoracic and Lung Transplantation team of Marie Lannelongue Hospital, where he developed his great interest in the field of Interventional Pulmonary Medicine, Thoracic Oncology, and Lung Transplantation.
Formed and trained under the supervision of Dr. Baldeyrou, in a relevantly short period of time, he was able to assist and perform thousands of bronchoscopies (flexible, rigid bronchoscopy, as well as endobronchial echoendoscopy), culminated in his excellence in the field of Interventional Pulmonary Medicine.
He is currently conducting his PhD thesis, a collaborative research between Cairo University and Centre Chirurgical Marie Lannelongue. I am greatly honored to express my deep respect and gratitude to Prof. EL Sorougi, Prof. AKL, Prof. Fadel and Dr. Baldeyrou for their faith in me and their continuous support.
Dr. Adrian Crutu
Dr. Crutu graduated in 2004 from CAROL DAVILA
Faculty of Medicine in Bucharest, Romania, with a Bachelor Degree in Medicine.
He started his pulmonary residency program at MARIUS NASTA
Pulmonology Institute in Bucharest, Romania, under the guidance of Prof. Miron Bogdan. He continued his pulmonary residency program in Brest, France, at CHU La Cavale Blanche in the pulmonary unit of Prof. Christophe Leroyer.
He obtained his master’s degree in Pulmonary Medicine in 2010 at MARIUS NASTA
Pulmonology Institute in Bucharest, Romania. The European Diploma in Pulmonary Medicine obtained in 2011 after the European Respiratory Society HERMES Examination confirmed the quality and the level of his competence in respiratory medicine.
From 2010 he is one of the pulmonologists of the Thoracic Surgery and Cardio-pulmonary Transplantation Department at Marie Lannelongue Hospital in Le Plessis-Robinson, France, working closely with thoracic surgeons under the guidance of Prof. Philippe Dartevelle and Prof. Elie Fadel.
Working closely from 2011 with Dr. Pierre Baldeyrou permitted him to achieve a level of excellence in the field of interventional pulmonology.
He has a constant interest for interventional pulmonology, thoracic oncology, and pulmonary transplantation, and he completed postgraduated formations related to these topics.
He is currently committed in developing different research projects in the field of interventional pulmonology.
Respectful acknowledgements to Prof. Bogdan, Prof. Leroyer, Prof. Dartevelle, Prof. Fadel, and Dr. Baldeyrou for their support and faith in me.
Foreword
Hervé Mal Prof., Head of the Department of Pulmonology and Lung Transplant, Bichât Hospital, Paris, France
When it comes to upper airways endoscopy, Pierre Baldeyrou is an expert. He is first of all an expert in flexible and rigid tracheobronchial endoscopy techniques. His vast clinical experience, covering diverse areas of thoracic oncology, surgery and lung transplantation, places him in the small group of experts of this field. Throughout his entire career he loved sharing his knowledge marking his good coaching and instructing skills. It would be hard to recall the number of young physicians whose mentor he was (and I was one of them once), be it in the subtleties of bronchial endoscopy or in improving their knowledge. And we all could admire his calm demeanor, his patience and kindness that accompanied him in this training. But oral sharing has its limitations. He chose to perfect his mentoring activity by penning a work in which he presented his knowledge in tracheobronchial semiology, normal, and pathological. We recognize his teaching rigor in the very formative path that he has followed, inviting us to proceed to a systematic analysis of each situation. I am sure that this work will become a big success. Through it, he will be able to share his knowledge while enjoying a well-deserved retirement. On behalf of the physicians he has trained, and of those that he will continue to train through this work, I thank him.
Preface
Pierre Baldeyrou, Interventional Bronchoscopy Unit, Division of Thoracic Surgery and Lung Transplantation, Marie Lannelongue Hospital, Paris, France
Since 1973, I have participated in the training of more than 50 young colleagues, some of whom were already experts and others entirely beginners. The importance of a basic body of knowledge in semiology for better use of rigid and flexible endoscopy had appeared to me to be essential.
Performing more than 50,000 bronchoscopies in Pulmonology University Institutions and internationally reputed thoracic surgery centers, as well as in anticancer center, was enriched by the daily confrontation with surgeons’ needs and cancer specialists’ requirements. This text is an updated written expression of courses taught to students specializing in pulmonology in Paris and in oncology at the Gustave Roussy Institute in Villejuif.
In his work titled Pathologie bronchique (Bronchial Pathology), published in 1956, Jean-Marcel Lemoine reiterates the definition of bronchial syndrome by Soulas and Mounier-Kuhn, regarding both the wall and the mucous membranes. The distinction between these two criteria, wall and mucous membranes, is always very obvious endoscopically. And J.M. Lemoine had very clearly insisted also on the distinction between trachea and bronchi, without too many justifications at the time, but today’s pathology entirely justifies this segmentation.
Infectious diseases have changed and the concept of necrosis has evolved. The tremendous progress in thoracic oncology surgeries and transplantation has witnessed new tracheobronchial alterations, which brings forward this up-to-date description, in the past few decades very few authors have taken interest strictly in endobronchial aspects. Anatomical and surgical approaches are not exactly superimposable with the physician’s direct view by fiber-optic endoscopy. Several semiology case reports would certainly be worth mentioning and taking into account in the future.
Regarding the training of young practitioners, reading recent publications, more oriented towards instrumentation and endoscopic techniques, is still recommended. And, while simulation training is the best approach of the future, it will always be based on systematic study of semiology, which is the starting point of an adequate interpretation of what is viewed. Similarly, endoscopic photo albums will be fully useful only once the normal aspects and their anatomical variants, as well as the pathological aspects, have been assimilated in all their diversities.
The purpose of this text is to prepare young physicians in using bronchial techniques and in limiting their feelings of solitude in this approach that they may sometimes have. It represents the experience of the main author, supported and justified by the other coauthors.
Endobronchial ultrasound belongs to fiber-optic bronchoscopy, but its very specific semiology does not belong to the same topic and will not be discussed here.
Dr. Pierre Baldeyrou, pulmonologist at Marie Lannelongue Hospital [HML (Hopital Marie Lannelongue)], in collaboration with Drs. Adrian Crutu, pulmonologist at HML and Bichat Hospital (Paris), Amir Hanna, pulmonologist at HML, Maria Ghigna, pathologist at HML.
Acknowledgment
This text is an acknowledgment and a respectful recognition of Profs. René Pariente, Michel Fournier, Thomas Tursz, Philippe Dartevelle, Elie Fadel, and Hervé Mal, who had faith in me and allowed me to bring my modest contribution to the tremendous progress in