Bronchoscopy

Bronchoscopy is performed after founding of suspected change with RTG examination. This examination helps to recognise changes in lungs, larynx, trachea and bronchi, enables a precise evaluation and location of the tumour and initial grade of disease advancement. Additionally during this examination collection of tissues samples from bronchi and lungs, as well as bronchial secretion for cytological examination (pulmonary tissue is taken with the help of biopsy instrument inserted through the bronchoscope’s canal) can be easily taken. In the examination bronchoscope is used, that is rigid pipe, ended with the optical system, inserted through the oral cavity to larynx, or flexible fiberscope inserted through the nose.

Before such procedure larynx or nasal duct are desensitised by inhalation. What is more, anxiolytic and atropine decreasing the risk of laryngospasm are usually administered. Despite the anaesthesia, bronchoscopy is unpleasant and painful.

Improvement of this method is fluorescence bronchoscopy, which enables recognition of not only very small neoplastic changes in lungs, but also precancerous states, invisible in conventional bronchoscopy. The next advantage is visualisation and precise localisation of neoplastic infiltrations of intramucous character.

Before the bronchoscopy (at least for 4 hours) patient cannot eat and drink. After operation, patient remains under observation for few hours. If pulmonary tissue was taken by biopsy, then X-ray of chest, to exclude possible complications, is necessary to perform.

Mediastinoscopy

This examination enables to view the mediastinum – space of chest between lungs - and material collection for examinations. For this aim mediastinoscope (flexible pipe ended with the optical system) is used. This examination is used in case of unexplained enlargement of lymph nodes and before the operation, to; study the process of tumour’s spread. The examination is performed also in operation theatre in general anaesthesia. Incision over the sternum is performed, through which the probe to mediastinum is inserted.

Gastroscopy

The next endoscopy examination is jest gastroscopy. Used endoscopes have diameter from 6 to 12mm big, and length from 30 to 150 cm.

Endoscopes of this type are equipped with tongs to collect tissue samples (serving afterwards to histopatholo­gical examinations). Examination of esophagus with this method is esophagoscopy, stomach - gastroscopy and duodenum - duodenoscopy. For this type of procedure usually oral cavity and pharynx are anesthetised. For a few hours before the examination patient must not eat. The examination alone takes about 10 minutes.

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