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REVIEW  COMPETENCE IN INTERVENTIONAL PULMONOLOGY Freefree

Panminerva Medica 2019 September;61(3):298-325

DOI: 10.23736/S0031-0808.19.03602-4

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

Competence in operative bronchoscopy

Giovanni GALLUCCIO 1, Lorenzo M. TRAMAGLINO 2, Roberto MARCHESE 3, Gian Pietro BANDELLI 4, Rossana VIGLIAROLO 5, Lorenzo CORBETTA 6

1 Unit of Thoracic Endoscopy, San Camillo Forlanini Hospital, Rome, Italy; 2 Unit of Respiratory System Diseases, San Giovanni Addolorata Hospital, Rome, Italy; 3 Unit of Thoracic Surgery and Interventional Pneumology, Oncologic Department, “La Maddalena”, Palermo, Italy; 4 Respiratory Unit, Santa Maria Bianca Hospital, AUSL Modena, Mirandola, Modena, Italy; 5 Unit of Pneumology, Sandro Pertini Hospital, Rome, Italy; 6 Department of Interventional Pneumology, University of Florence, Florence, Italy



We describe the current knowledge and skills for the main techniques of operative bronchoscopy and their applications in the treatment of malignant and benign central airway disorders. Rigid bronchoscopy has a history of over 100 years. The use of rigid bronchoscopy was abandoned upon the introduction of the fiberoptic bronchoscope but has made a reappearance with the development of interventional pulmonology in the late nineteenth and early twentieth century. The advantages of rigid bronchoscopy include allowing simultaneous procedures, such as ablation, debulking and suctioning, without limiting ventilation but at the moment there are no standard approaches to perform the procedure. Rigid bronchoscopy also plays a vital role in stent placement, repositioning, maintenance and removal. An interventional pulmonology practice should only be developed when there is a locoregional unmet medical need and when a dedicated interventional pulmonology unit can be guaranteed. These departments should be available 7 days a week and should provide a fast and appropriate response to referrals in emergency cases. There is a clear need to define a competency-based training program for rigid bronchoscopy, including stent placement. An optimal, multimodality training program for bronchoscopy should include didactic lectures, web-based learning, case-based reviews and hands-on training.


KEY WORDS: Bronchoscopy - Self-expandable metallic stents - Ablation techniques - Laser therapy

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