Application of Simple Imaging Technique for Fluorescence Bronchoscope

It was reported that the significant spectral difference of autofluroescence induced by laser light between cancer and normal tissue. A fluorescence bronchoscope system with simple light source and light filter was newly developed. In this paper, the detection of autofluorescence from bronchogenic dysplasia with this system was reported

The Development of a New Setup for Video-assisted Thoracic Surgery

In order to accomplish video-assisted thoracic surgery (VATS) in a much easier and safer way, especially for assistant operators, we have developed a new display system for VATS. The original thoracoscope has been designed for this new system. The monitor is fixed at approximately 10 cm away from the surface of the chest wall just above the operative field. In using this procedure, the operator and assistants can see the patient and the monitor at the same time. According to this new idea, the previous problem in the area of hand–eye coordination and the three-dimensional understanding of this procedure can be improved compared to the image of the conventional thoracoscopy, because it is not necessary for the operator and assistants to look up at the monitors. When the thoracoscopy was placed in an adequate position to resect the target pathology, this new system led to good and easy handling of instruments, as it was with the standard thoracotomy

A Unique Case of Adenoid Cystic Carcinoma of the Left Main Bronchus

A unique case of adenoid cystic carcinoma of the left main bronchus is reported

Synchronous Quadruple Lung Cancer Treated Curatively by Photodynamic Therapy

A 54-year-old male was diagnosed as having synchronous quadruple early stage lung cancer. All four tumors showed the same histologic type of in-situ or microinvasive squamous cell carcinoma, but existed independently in different bronchi. Photodynamic therapy of these four lesions was successfully performed by fiberoptic bronchoscopy because of the patient's poor pulmonary function. The patient is alive and well 51 months later

Effectiveness of Photodynamic Therapy and Nd-YAG Laser Treatment for Obstructed Tracheobronchial Malignancies

Since 1980, advanced lung carcinomas were treated with palliative laser therapy for the purpose of opening the endobronchial stenosis and obstruction by either photodynamic therapy (PDT) or Nd-YAG laser treatment at Tokyo Medical University. A total of 258 lesions were treated, 81 by PDT and 177 by Nd-YAG laser treatment. PDT achieved effective results in 61 (75%) of 81 lesions. In the Nd-YAG laser group, 143 (81%) of 177 lesions showed effective results. When the tumor was located in the trachea or main bronchi, effective results were obtained in 73% (19 of 26) of cases treated by PDT and in 93% of cases (64 of 69) treated by Nd-YAG laser. However, in cases in which the tumor was located in lobar or segmental bronchi, the tumor response was effective in 76% (42 of 55) of PDT-treated patients and 73% (79 of 108) of Nd-YAG laser-treated patients. With a mortality rate of 0%, the greatest advantage of PDT over Nd-YAG treatment was safety. Considering complications, PDT seems to be useful for obstruction of lobar and segmental bronchus. Nevertheless, when deciding among alternative therapies, physicians treating patients with advanced lung carcinoma should give careful consideration to the benefit and complications of both laser therapies and decide the most suitable modality

An Early Stage Diffuse B-Cell Lymphoma Within a Visible Site of Bronchofiberscope Accompanied by Peripheral Lung Cancer

We report a case of non-Hodgkin's lymphoma found at the orifice of right B2 accompanied by peripheral lung cancer in a 66-year-old asymptomatic man. Chest X-ray films showed a mass shadow in the left lower lung field. Transbronchial lung biopsy of left S9 demonstrated squamous cell carcinoma. Simultaneously wall thickening at the orifice of the right B2 was found coincidentally. The biopsy specimen from that site showed non-Hodgkin's lymphoma (diffuse B-cell type). After left lower lobectomy, systemic chemotherapy was performed. It is rare for malignant lymphoma to be recognized bronchofiberscopically

Early Detection of Bronchial Lesions Using System of Autofluorescence Endoscopy (SAFE) 1000

Recently several endoscopic fluorescence detection systems have been developed. In some of them, laser light was used for the excitation of autofluorescence, and sophisticated techniques were also necessary to amplify the fluorescence signal as well

Lung Cancers Treated With Photodynamic Therapy and Surgery

Laser endoscopic surgery, especially the effectiveness of photodynamic therapy (PDT) using Photofrin as a photosensitizer, has now achieved a status as effective treatment modality for lung cancer. Twenty-six lung cancer patients received the preoperative PDT for the purpose of either reducing the extent of resection or increasing operability. Bronchoscopical PDT is performed with topical anesthesia approximately 48 h after the intravenous injection of 2.0 mg/kg body weight of Photofrin. Operation was performed 2–9 weeks after initial PDT. The initial purpose of PDT, i.e. either to reduce the extent of resection or convert inoperable disease to operable status, was achieved in 22 out of 26 patients treated. The survival rate of T3 (main bronchus invasion) cases treated by surgery alone increased significantly from 50.9% to 60.0% with the application of preoperative PDT. This remarkable result may imply that this new option of PDT as preoperative laser irradiation may contribute to the management of advanced lung malignancy