A Retrospective Analysis of Interventional Flexible Bronchoscopic Procedures in Pediatric Patients

Yıl 2025, Cilt: 35 Sayı: 5, 1020 - 1031, 28.10.2025

Aslı İmran Yılmaz , Dirk Schramm , Sevgi Pekcan

https://doi.org/10.54005/geneltip.1741443

Öz

Background: Pediatric interventional pulmonology has significantly advanced in recent years with the integration of minimally invasive techniques such as cryotherapy, balloon dilation, and endobronchial biopsies. Flexible bronchoscopy, once primarily a diagnostic tool, has now become an essential therapeutic modality in managing complex pediatric airway and pulmonary conditions. This study aimed to retrospectively evaluate interventional procedures performed using flexible bronchoscopy in pediatric patients over a one-year period. Methods:
A retrospective review was conducted on pediatric patients who underwent interventional flexible bronchoscopy between June 2024 and June 2025. Data collected included demographic information, indications for bronchoscopy, types of interventional procedures performed, bronchoscopic findings, and observed complications. All procedures were conducted under sedation or general anesthesia by experienced pediatric pulmonologists using age-appropriate bronchoscopes. Results: A total of 24 patients (13 males) with a mean age of 91 months underwent interventional bronchoscopic procedures. The most common indications included subglottic stenosis (16.7%), suspected primary ciliary dyskinesia (16.7%), interstitial lung disease (20.8%), and foreign body aspiration (16.7%). A total of 27 procedures were performed, including balloon dilatation (22.2%), cryobiopsy (37.0%), foreign body removal (14.8%), and cryodevitalization (11.1%). The complication rate was low, with only mild bleeding in two patients and moderate bleeding in one; no pneumothorax was reported. Conclusion: Pediatric flexible bronchoscopy is a safe and effective method for both diagnosis and therapy in children with complex respiratory conditions. With the availability of thinner instruments and increased expertise, advanced interventional techniques are now more accessible and applicable in pediatric populations. Structured training programs and interdisciplinary collaboration are essential to further develop and standardize pediatric interventional pulmonology practices.

Anahtar Kelimeler

Bronchoscopy , Pediatric , Interventional Bronchoscopy , Flexible Bronchoscopy

Pediatrik Hastalarda Girişimsel Fleksible Bronkoskopik İşlemlerin Retrospektif Analizi

Öz

Giriş: Pediatrik girişimsel pulmonoloji, kriyoterapi, balon dilatasyonu ve endobronşiyal biyopsi gibi minimal invaziv tekniklerin entegrasyonu ile son yıllarda önemli ölçüde ilerleme kaydetmiştir. Başlangıçta yalnızca tanısal amaçlarla kullanılan fleksibl bronkoskopi, artık karmaşık pediatrik hava yolu ve akciğer hastalıklarının tedavisinde vazgeçilmez bir yöntem hâline gelmiştir. Bu çalışmanın amacı, bir yıllık süre içerisinde pediatrik hastalara uygulanan girişimsel fleksibl bronkoskopik işlemleri retrospektif olarak değerlendirmektir. Yöntem:
Haziran 2024 ile Haziran 2025 tarihleri arasında girişimsel fleksibl bronkoskopi uygulanan pediatrik hastalar retrospektif olarak incelendi. Hastalara ait demografik bilgiler, bronkoskopi endikasyonları, uygulanan girişimsel işlem türleri, bronkoskopik bulgular ve gözlenen komplikasyonlar kaydedildi. Tüm işlemler, yaşa uygun bronkoskoplar kullanılarak, deneyimli pediatrik göğüs hastalıkları uzmanları tarafından, sedasyon veya genel anestezi altında gerçekleştirildi. Bulgular: Toplam 24 hasta (13’ü erkek), ortalama 91 ay yaşında idi. En sık bronkoskopi endikasyonları; subglottik stenoz (%16,7), primer siliyer diskinezi şüphesi (%16,7), interstisyel akciğer hastalığı (%20,8) ve yabancı cisim aspirasyonu (%16,7) olarak belirlendi. Toplam 27 girişimsel işlem uygulandı. Bu işlemler arasında balon dilatasyonu (%22,2), kriyobiyopsi (%37,0), yabancı cisim çıkarılması (%14,8) ve kriyodevitalizasyon (%11,1) yer aldı. Komplikasyon oranı düşüktü; iki hastada hafif, bir hastada ise orta düzeyde kanama görüldü. Pnömotoraks vakası saptanmadı. Sonuç: Pediatrik fleksibl girişimsel bronkoskopi, karmaşık solunum yolu hastalıklarının tanı ve tedavisinde güvenli ve etkili yöntemlerdir. Daha ince enstrümanlara olan erişim ve artan uzmanlık sayesinde, ileri girişimsel teknikler artık çocuk hastalarda daha yaygın ve uygulanabilir hâle gelmiştir. Bu alanın gelişimi için yapılandırılmış eğitim programları ve disiplinler arası iş birliği büyük önem taşımaktadır.

Anahtar Kelimeler

Bronkoskopi , Çocuk , Girişimsel Bronkoskopi , Fleksibl Bronkoskopi

Kaynakça

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