HROMOBRONKHOSKOPIYA

From Big Medical Encyclopedia

HROMOBRONHOSKOPYYa (Greek chroma color, coloring + a bronchial tube \and \+ Greek skopeo to consider, investigate) — the method of a bronchoscopic research based on ability of malignant new growths of bronchial tubes selectively to be painted methylene blue at preservation of natural color of not changed mucous membrane of bronchial tubes after washing off of dye from it. Hromobronkhoskopiya is applied by hl. obr. for the purpose of differential diagnosis of benign and malignant tumors of bronchial tubes.

The method of a hromobronkhoskopiya is offered in 1979 by I. Lukomsky with sotr.

The indication to a hromobronkhoskopiya is suspicion of the malignant and benign tumors of bronchial tubes (see Lungs) located in visibility limits of rigid and flexible bronchoscopes (see Bronkhoezofagoskop).

Hromobronkhoskopiya plays an important role in diagnosis of nek-ry forms endofitno of the growing tumors of bronchial tubes, it is not enough what differing by outward from a surrounding mucous membrane. Coloring of their surface during a bronkhoskopiya allows to execute more precisely a biopsy and to establish the diagnosis. Especially valuable the hromobronkhoskopiya appears in diagnosis of early forms of bronchogenic cancer. Hromobronkhoskopiya can also matter at delimitation of spread of a tumor in the proximal direction that is important during the planning of volume of an operative measure.

As contraindications serve serious condition of patients, intolerance of dye, impossibility of full removal from a gleam of a bronchial tree of the solutions entered into it paints and washing out at localization of a tumor in a trachea or a primary bronchus, and also existence of the general contraindications to this or that type of a diagnostic bronkhoskopiya.

The catheter of the corresponding length, syringes, the bronchoscopic sprayer, aspirators are necessary for a hromobronkhoskopiya the respiratory bronchoscope or bronkhofibroskop (the last shall have the biopsionny channel).

Methylene blue is applied on a mucosal surface of a cover of bronchial tubes during a bronkhoskopiya or a bronkhofibroskopiya (see Bronkhoskopiya, a bronkhofibroskopiya, t. 15, additional materials). After survey of a bronchial tree via the bronchoscope suspicious sites of bronchial tubes clear of slime by means of 0,5% of solution of trypsin or chemical opsin, and then wash out 5% solution of hydro-sodium carbonate. After that by means of a spray or through a catheter apply 0,2 — 0,4% on a mucous membrane of bronchial tubes solution of methylene blue. In 1 min. bronchial tubes wash out isotonic solution of sodium chloride before full removal of dye then examine and if necessary photograph patholologically the changed sites. The procedure is completed a biopsy (see) sites of a mucous membrane of a bronchial tube or a tumor, painted and neighboring to them.

From not reversed mucous membrane dye is washed away. Does not change coloring and a surface of benign tumors of bronchial tubes. The surface of malignant tumors is, as a rule, painted in blue color and considerably differs from not changed mucous membrane surrounding it (tsvetn. the tab., Art. 48, fig. 4 — 7). Fabric of planocellular keratosic cancer is especially well painted. Fibrin is also painted in rich blue color that can sometimes become the reason of false assessment of results of a hromobronkhoskopiya. In this regard the biopsy and morfol is necessary. a research of all painted sites of a bronchial wall.

At the correct definition of indications and the accounting of contraindications to a hromobronkhoskopiya of specific complications it is not observed. During incomplete removal of dye and the washing-out solutions from a gleam of bronchial tubes development of pneumonia is possible (see); at disturbance of the equipment of a bronkhoskopiya the trachea and bronchial tubes can be injured (see Bronkhoskopiya).

Bibliography: JI at to about m with to and y G. I., etc. Bronkhopulmonologiya, page 210, M., 1982; L at to about m with to and y G. I., etc. Hromobronkhoskopiya in diagnosis of tumors of bronchial tubes, Grudn. hir., No. 3, page 47, 1979; YU.V. Blue, and in r and l e N to about Ya. V, and Vasya of l e in V. S. Hromobronkhoskopiya in diagnosis of a recurrence of cancer of bronchial tubes, Surgery, No. 10, page 14, 1980; About v with

h i n n i-k o v A. A. a. o. Chromobronchoscopy in the diagnosis of bronchial tumors, Endoscopy, v. 12, p. 147, 1980. A. A. Ovchinnikov.

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