Flexible Bronchoscopy in Children: The Marmara University Division of Pediatric Pulmonology Experience

Öz

Objective: The use of flexible bronchoscopy for diagnosis and/or treatment in pediatric patients has increased considerably in recent years with new indication areas. The aim of the current study is to present our experience with 732 flexible bronchoscopy procedures performed over 5 years in our Pediatric Pulmonology Clinic. Materials and Method: The study involves children under the age of 18 years who’ve undergone flexible bronchoscopy. Demographic characteristics, flexible bronchoscopy indications and findings, complications, and bronchoalveolar lavage results have been recorded. Results: Patients’ median age is 5 years (range from 2-10 years). The most common indication of FB is recurrent lower respiratory tract infection (29.6%), followed by chronic cough (16.4%). Of the patients 49 (6.7%) had an immunodeficiency and 42 (5.7%) had a malignancy. The bronchoscopic evaluations revealed normal airway anatomies in 250 (34.2%) patients. At least one pathological finding was detected in 482 (65.8%) patients. The most common findings were increased airway secretions in 268 (36.6%) patients and bronchomalacia in 66 (9%) patients. Microbiological growth presented for at least one microorganism in 111 (20.8%) patients. Haemophilus infleunzae was the most frequently identified bacteria. No major complications were observed. Conclusion: Flexible bronchoscopy is very valuable for patients with recurrent lower respiratory tract infections in terms of bronchoalveolar lavage culture results and appropriate antibiotic therapy. Flexible bronchoscopy is essential for detecting laryngomalacia or secondary airway lesions in patients with stridor and is an important tool for definitively diagnosing bronchomalacia in patients with persistent wheezing and chronic cough.

Çocuklarda Fleksibl Bronkoskopi- Marmara Çocuk Göğüs Hastalıkları Deneyimi

Öz

Amaç: Fleksibl bronkoskopinin pediatrik hastalarda tanı ve/veya tedavi amaçlı kullanımı yeni endikasyon alanlarıyla son yıllarda oldukça artış göstermiştir. Bu çalışmada amacımız Çocuk Göğüs Hastalıkları kliniğimizde 5 yıllık sürede gerçekleştirdiğimiz 732 fleksibl bronkoskopi işlemi ile ilgili deneyimimizi sunmaktır. Gereç ve Yöntem: 2016-2021 yılları arasında fleksibl bronkoskopi işlemi uygulanan 18 yaş altı çocuklar çalışmaya dahil edildi. Hastaların tıbbi kayıtları incelendi ve demografik özellikleri, bronkoskopi endikasyonları, bronkoskopi bulguları, komplikasyonlar ve bronkoalveoler lavaj sonuçları kayıt edildi. Bulgular: Hastaların ortanca yaşı 5 yıl idi. Fleksibl bronkoskopinin en sık endikasyonu tekrarlayan alt solunum yolu enfeksiyonu (%29,6), ikinci en sık neden kronik öksürük (%16,4) idi. Fleksibl bronkoskopi yapılan hastaların 49’unda (%6,7) immun yetmezlik, 42’sinde (%5,7) malignite mevcuttu. Bronkoskopik değerlendirmeler 250 (%34,2) hastada normal hava yolu anatomisi ortaya koyarken, 482 (%65,8) hastada en az bir patolojik bulgu saptadı. En sık görülen bulgular 268 (%36,6) hastada havayolu sekresyonları artışı ile 66 (%9) hastada bronkomalazi idi. Hastaların 111’inde (%20,8) mikrobiyolojik üreme mevcuttu. Haemophilus influenzae en sık bulunan bakteri idi. Hiçbir hastada majör komplikasyon gözlenmedi. Sonuç: Fleksibl bronkoskopi, tekrarlayan alt solunum yolu enfeksiyonu olan hastalarda bronkoalveoler lavaj kültür sonuçları ile uygun antibiyotik tedavisinin verilebilmesi açısından çok önemlidir. Stridoru olan hastalarda laringomalazi veya ikincil hava yolu lezyonlarının; persistan hışıltı ve kronik öksürüğü olan hastalarda bronkomalazinin kesin tanısı için önemli bir araçtır.

Anahtar Kelimeler

• Çocuk
• fleksibl bronkoskopi
• bronkoalveoler lavaj

Kaynakça

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