Clinical efficacy of bronchoscope in the treatment of transbronchial broncholithiasis_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

WANG Hong , ZHANG Li ,  WAN Yixin

Department of Respiratory Medicine, The Second Hospital of Lanzhou University, Lanzhou, Gansu 730030, P. R. China;

Corresponding author：

WAN Yixin, Email: 1311098171@qq.com

Keywords：

Broncholithiasis; Transbronchial broncholiths; Bronchoscope

DOI：

10.7507/1671-6205.201806017

Video：

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Objective To evaluate the efficacy and safety of bronchoscope in the treatment of transbronchial broncholiths.Methods The clinical data, treatment methods, clinical efficacy and complications of 18 patients who were diagnosed with transbronchial broncholiths were etrospectively reviewed in the Respiratory Department of the Second Hospital of Lanzhou University during January 2010 to December 2017.Results Eighteen patients were diagnosed by bronchoscopy with a total of 22 pieces of stone for transbronchial broncholiths. An elective surgical procedure was performed in 2 cases. Six cases were treated with removing broncholiths once by foreign body forceps under bronchoscope. Repeated treatments were performed in 10 patients. Two cases underwent massive hemorrhage in the process of one-time broncholiths removal by foreign body forceps under bronchoscope, and one case suffered from bronchial fistula after the broncholiths removal, all of the above 3 patients underwent surgical treatment. All patients were followed up for 5 months without any long-term complications.Conclusions Removal of broncholithiasis by bronchoscopic forceps can effectively treat transbronchial broncholiths with low complication and high safety. If the broncholiths cause severe distal lung tissue injury, massive hemoptysis, bronchial fistula, or the diagnosis is unclear, surgical treatment is required. When the transbronchial broncholith is difficult to remove completely at once, batch could be chosen. First, to remove one portion which causes the obstruction of airway; and then, to remove the left part of the transbronchial broncholith by stages.

Citation： WANG Hong, ZHANG Li, WAN Yixin. Clinical efficacy of bronchoscope in the treatment of transbronchial broncholithiasis. Chinese Journal of Respiratory and Critical Care Medicine, 2019, 18(1): 65-69. doi: 10.7507/1671-6205.201806017 Copy

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4.	Ferguson JS, Rippentrop JM, Fallon B, et al. Management of obstructing pulmonary broncholithiasis with three-dimensional imaging and holmium laser lithotripsy. Chest, 2006, 130(3): 909-912.
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6.	Olson EJ, Utz JP, Prakash UB. Therapeutic bronchoscopy in broncholithiasis. Am J Respir Crit Care Med, 1999, 160(3): 766-770.
7.	金宇星, 姜格宁, 丁嘉安, 等. 支气管结石症 27 例诊断及治疗评价. 中华结核和呼吸杂志, 2010, 33(12): 946-947.
8.	Hammoud ZT, Rose AS, Hage CA, et al. Surgical management of pulmonary and mediastinal sequelae of histoplasmosis: a challenging spectrum. Ann Thorac Surg, 2009, 88(2): 399-403.
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11.	De S, De S. Broncholithiasis. Lung India, 2008, 25(4): 152-154.
12.	谢冬, 金宇星, 费苛, 等. 59 例支气管结石病的外科治疗. 中华胸心血管外科杂志, 2015, 31(4): 217-220.
13.	Jin YX, Jiang GN, Jiang L, et al. Diagnosis and treatment evaluation of 48 cases of broncholithiasis. Thorac Cardiovasc Surg, 2016, 64(5): 450-455.
14.	Wiese TA. Mainstem to mainstem bronchial fistula from broncholithiasis. J Bronchology Interv Pulmonol, 2012, 19(1): 78-80.

1. Dakkak M, Siddiqi F, Cury JD. Broncholithiasis presenting as bronchiectasis and recurrent pneumonias. BMJ Case Rep, 2015, 2015: bcr2014209035.
2. Hekimoglu K, Gundogdu S. Early adolescent primary ciliary dyskinesia associated with broncholithiasis. Pediatr Pulmonol, 2008, 43(7): 714-716.
3. 董宇超, 李强, 白冲, 等. 支气管结石症的临床识别及支气管镜下处理. 中华结核和呼吸杂志, 2008, 31(1): 18-21.
4. Ferguson JS, Rippentrop JM, Fallon B, et al. Management of obstructing pulmonary broncholithiasis with three-dimensional imaging and holmium laser lithotripsy. Chest, 2006, 130(3): 909-912.
5. 程渊, 章巍, 张红, 等. 经支气管镜钬激光碎石在支气管结石患者治疗中的应用. 中华结核和呼吸杂志, 2017, 40(1): 29-33.
6. Olson EJ, Utz JP, Prakash UB. Therapeutic bronchoscopy in broncholithiasis. Am J Respir Crit Care Med, 1999, 160(3): 766-770.
7. 金宇星, 姜格宁, 丁嘉安, 等. 支气管结石症 27 例诊断及治疗评价. 中华结核和呼吸杂志, 2010, 33(12): 946-947.
8. Hammoud ZT, Rose AS, Hage CA, et al. Surgical management of pulmonary and mediastinal sequelae of histoplasmosis: a challenging spectrum. Ann Thorac Surg, 2009, 88(2): 399-403.
9. Henry NR, Hinze JD. Broncholithiasis secondary to pulmonary actinomycosis. Respir Care, 2014, 59(3): e27-e30.
10. Hammoune N, Janah H. Broncholithiasis: a rare complication of pulmonary tuberculosis. Pan Afr Med J, 2015, 20: 206.
11. De S, De S. Broncholithiasis. Lung India, 2008, 25(4): 152-154.
12. 谢冬, 金宇星, 费苛, 等. 59 例支气管结石病的外科治疗. 中华胸心血管外科杂志, 2015, 31(4): 217-220.
13. Jin YX, Jiang GN, Jiang L, et al. Diagnosis and treatment evaluation of 48 cases of broncholithiasis. Thorac Cardiovasc Surg, 2016, 64(5): 450-455.
14. Wiese TA. Mainstem to mainstem bronchial fistula from broncholithiasis. J Bronchology Interv Pulmonol, 2012, 19(1): 78-80.

Chinese Journal of Respiratory and Critical Care Medicine

Clinical efficacy of bronchoscope in the treatment of transbronchial broncholithiasis

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