Skip to main content

Endoskopische invasive Diagnostik in der Thoraxchirurgie und Thoraxpunktion

  • Chapter
  • First Online:
Thoraxchirurgie

Part of the book series: Springer Reference Medizin ((SRM))

Zusammenfassung

Die Bronchoskopie ist eine zentrale Untersuchungsmethode in der Diagnostik pulmonaler Erkrankungen. Innerhalb der Thoraxchirurgie ergeben sich folgende Indikationsfelder: Biopsie zentral gelegener Prozesse und peripherer Verschattungen und Rundherde; mediastinales Staging bei Lungentumoren; präoperative Inspektion des tracheobronchialen Situs; intraoperative Inspektion des operativen Lokalbefundes; postoperative Inspektion der Anastomose(n); interventionelle Eingriffe; Infektionsdiagnostik bei Bronchitiden und (postoperativen) Pneumonien. Eine Bronchoskopie kann mittels flexiblem oder starrem Bronchoskop durchgeführt werden. Erstere wird heute meist unter Propofol-Gabe durchgeführt, letztere erfordert eine Vollnarkose und Jet-Beatmung. Die mediastinale Evaluation durch EBUS/EUS-Untersuchung steht heute am Anfang der Diagnostik von Patienten mit potenziell operablen nichtkleinzelligen Lungentumoren. Die Bedeutung der transthorakalen Sonografie ist zuletzt erheblich gestiegen. Sonografisch sind besonders Pleuraergüsse und thoraxwandnahe Prozesse sehr gut darstellbar und Gegenstand sonografisch gesteuerter Punktionen. Vorteile der Sonografie umfassen die freie Verfügbarkeit, fehlende Strahlenbelastung und beliebige Wiederholbarkeit sowie die geringen Kosten.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 289.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 299.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Literatur

  • Afessa B, Hubmayr RD, Vetter EA, Keegan MT, Swanson KL, Baddour LM, Cockerill FR 3rd, Peters SG (2006) Bronchoscopy in ventilator-associated pneumonia: agreement of calibrated loop and serial dilution. Am J Respir Crit Care Med 173:1229–1132

    Article  PubMed  Google Scholar 

  • Babiak A, Hetzel J, Krishna G, Fritz P, Moeller P, Balli T, Hetzel M (2009) Transbronchial cryobiopsy: a new tool for lung biopsies. Respiration 78:203–208

    Article  PubMed  Google Scholar 

  • Baselski VS, el-Torky M, Coalson JJ, Griffin JP (1992) The standardization of criteria for processing and interpreting laboratory specimens in patients with suspected ventilator-associated pneumonia. Chest 102(5 Suppl 1):571S–579S

    Article  CAS  PubMed  Google Scholar 

  • Dickson PR, Erb-Downward JR, Prescott HC, Martinez FJ, Curtis JL, Lama VN, Huffnagle GS (2014) Analysis of culture-dependent versus culture-independent techniques for identification of bacteria in clinically obtained bronchoalveolar lavage fluid. J Clin Microbiol 52:3605–3613

    Google Scholar 

  • Du Rand IA, Barber PV, Goldring J, Lewis RA, Mandal S, Munavvar M, Rintoul RC, Shah PL, Singh S, Slade MG, Woolley A, on behalf of the British Thoracic Society Interventional Bronchoscopy Guideline Group (2011) British Thoracic Society guideline for advanced diagnostic and therapeutic flexible bronchoscopy in adults. Thorax 66:iii1–iii21

    PubMed  Google Scholar 

  • Ernst A, Anantham D, Eberhardt R, Krasnik M, Herth FJ (2008) Diagnosis of mediastinal adenopathy-real-time endobronchial ultrasound guided needle aspiration versus mediastinoscopy. J Thorac Oncol 3:577–582

    Article  PubMed  Google Scholar 

  • Ewig S (Hrsg) (2017) Nosokomiale Pneumonie. Springer, Berlin; insbesondere Kapitel 8–10

    Google Scholar 

  • Giesa C, Heining L, Hecker E, Ewig S (2016) Severe complications of ultrasound guided transbronchial needle aspiration – a case series and review of the literature. Pneumologie 70:23–27

    Article  CAS  PubMed  Google Scholar 

  • Gompelmann D, Herth FJ (2014) Role of endobronchial and endoscopic ultrasound in pulmonary medicine. Respiration 87:3–8

    Article  CAS  PubMed  Google Scholar 

  • Herth FJ, Eberhardt R, Vilmann P, Krasnik M, Ernst A (2006a) Real-time endobronchial ultrasound guided transbronchial needle aspiration for sampling mediastinal lymph nodes. Thorax 61:795–798

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Herth FJ, Ernst A, Eberhardt R, Vilmann P, Dienemann H, Krasnik M (2006b) Endobronchial ultrasound-guided transbronchial needle aspiration of lymph nodes in the radiologically normal mediastinum. Eur Respir J 28:910–914

    Article  CAS  PubMed  Google Scholar 

  • Herth FJ, Rabe KF, Gasparini S, Annema JT (2006c) Transbronchial and transoesophageal (ultrasound-guided) needle aspirations for the analysis of mediastinal lesions. Eur Respir J 28:1264–1275

    Article  CAS  PubMed  Google Scholar 

  • Herth FJ, Eberhardt R, Krasnik M, Ernst A (2008) Endobronchial ultrasound-guided transbronchial needle aspiration of lymph nodes in the radiologically and positron emission tomography-normal mediastinum in patients with lung cancer. Chest 133:887–891

    Article  PubMed  Google Scholar 

  • Herth FJ, Krasnik M, Kahn N, Eberhardt R, Ernst A (2010) Combined endoscopic-endobronchial ultrasound-guided fine-needle aspiration of mediastinal lymph nodes through a single bronchoscope in 150 patients with suspected lung cancer. Chest 138:790–794

    Article  PubMed  Google Scholar 

  • Johannson KA, Marcoux VS, Ronksley PE, Ryerson CJ (2016) Diagnostic yield and complications of transbronchial lung cryobiopsy for interstitial lung disease: a systematic review and metaanalysis. Ann Am Thorac Soc 13:1828–1838

    PubMed  Google Scholar 

  • Mathis G (Hrsg) (2015) Bildatlas der Lungensonographie, 6. Aufl. Springer, Berlin

    Google Scholar 

  • Nakhosteen JA, Khanavkar B, Darwiche K, Scherff A, Hecker E, Ewig S (2009) Atlas und Lehrbuch der Thorakalen Endoskopie: Bronchoskopie, Thorakoskopie, 4. Aufl. Springer, Berlin

    Google Scholar 

  • Ost DE, Ernst A, Grosu HB, Lei X, Diaz-Mendoza J, Slade M, Gildea TR, Machuzak M, Jimenez CA, Toth J, Kovitz KL, Ray C, Greenhill S, Casal RF, Almeida FA, Wahidi M, Eapen GA, Yarmus LB, Morice RC, Benzaquen S, Tremblay A, Simoff M, AQuIRE Bronchoscopy Registry (2015) Complications following therapeutic bronchoscopy for malignant central airway obstruction: results of the AQuIRE Registry. Chest. 148:450–471

    Article  PubMed  PubMed Central  Google Scholar 

  • Ostendorf U, Scherff A, Khanavkar B, Ewig S, Hecker E (2011) Diagnosis of peripheral lung lesions by EBUS-guided TBB in routine practice. Pneumologie 65:730–735

    Article  CAS  PubMed  Google Scholar 

  • Ravaglia C, Wells AU, Tomassetti S, Gurioli C, Gurioli C, Dubini A, Cavazza A, Colby TV, Piciucchi S, Puglisi S, Bosi M, Poletti V (2019) Diagnostic yield and risk/benefit analysis of trans-bronchial lung cryobiopsy in diffuse parenchymal lung diseases: a large cohort of 699 patients. BMC Pulm Med 19:16

    Article  PubMed  PubMed Central  Google Scholar 

  • Romagnoli M, Colby TV, Berthet J-P, Gamez AS, Mallet J-P, Serre I, Cancellieri A, Cavazza A, Solovei L, Dell'Amore A, Dolci G, Guerrieri A, Reynaud P, Bommart S, Zompatori M, Dalpiaz G, Nava S, Trisolini R, Suehs CM, Vachier I, Molinari N, Bourdin A (2019) Poor concordance between sequential transbronchial lung cryobiopsy and surgical lung biopsy in the diagnosis of diffuse interstitial lung diseases. Am J Respir Crit Care Med 199:1249–1256

    Article  PubMed  Google Scholar 

  • Vilmann P, Clementsen PF, Colella S, Siemsen M, De Leyn P, Dumonceau JM, Herth FJ, Larghi A, Vazquez-Sequeiros E, Hassan C, Crombag L, Korevaar DA, Konge L, Annema JT (2015) Combined endobronchial and esophageal endosonography for the diagnosis and staging of lung cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline, in cooperation with the European Respiratory Society (ERS) and the European Society of Thoracic Surgeons (ESTS). Endoscopy 47:545–559

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Section Editor information

Rights and permissions

Reprints and permissions

Copyright information

© 2023 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Ewig, S., Scherff, A. (2023). Endoskopische invasive Diagnostik in der Thoraxchirurgie und Thoraxpunktion. In: Hoffmann, H., Ludwig, C., Passlick, B. (eds) Thoraxchirurgie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-59146-8_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-59146-8_9

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-59145-1

  • Online ISBN: 978-3-662-59146-8

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics