Analyzing Bronchoscopic Damage

DOI
  • Sawada Toru
    Department of Surgery, National Hospital Organization Higashi Tokushima Medical Center
  • Yoshida Mitsuteru
    Department of Thoracic, Endocrine Surgery and Oncology, Institute of Health Bioscience, the University of Tokushima Graduate School
  • Kajiura Kouichirou
    Department of General Thoracic Surgery, Urazoe General Hospital
  • Kawakita Naoya
    Department of Thoracic, Endocrine Surgery and Oncology, Institute of Health Bioscience, the University of Tokushima Graduate School
  • Tsuboi Mitsuhiro
    Department of General Thoracic Surgery, Tokushima Prefectural Central Hospital
  • Toba Hiroaki
    Department of Thoracic, Endocrine Surgery and Oncology, Institute of Health Bioscience, the University of Tokushima Graduate School
  • Kawakami Yukikiyo
    Department of Thoracic, Endocrine Surgery and Oncology, Institute of Health Bioscience, the University of Tokushima Graduate School
  • Takizawa Hiromitsu
    Department of Thoracic, Endocrine Surgery and Oncology, Institute of Health Bioscience, the University of Tokushima Graduate School
  • Kondo Kazuya
    Department of Thoracic, Endocrine Surgery and Oncology, Institute of Health Bioscience, the University of Tokushima Graduate School
  • Tangoku Akira
    Department of Thoracic, Endocrine Surgery and Oncology, Institute of Health Bioscience, the University of Tokushima Graduate School

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Other Title
  • 気管支鏡の破損を分析する

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<p>Background. Bronchoscopy is used in many procedures, such as endoscopic ultrasonography, tracheal stent placement, placement of Endobronchial Watanabe Spigots, and preoperative coil marking. However, bronchoscopy is a complicated procedure, and breakage can occur due to external forces. Bronchoscope breakage is associated with both adverse economic effects and patient-related consequences, since these devices are expensive and their breakage may increase the rates of complications and cause interruptions in examinations and treatments, if repairs are necessary. Purpose. We considered the causes of bronchoscope damage at our hospital in order to design future preventive measures and precautions. Method. We examined the bronchoscope type, their breakage status, and the repair costs for the 246 bronchoscopes in our department between January 2015 and November 2017. Result. A bronchoscope was damaged in 3 of the 246 cases, resulting in a damage rate of 1.2%. Damage to the bronchoscope occurred during yttrium-aluminium-garnet laser resection (n=2) because of thermal damage to the suction forceps port, during a right upper lobe biopsy (n=1) because of the forceps contacting the curved part, and during an endobronchial ultrasound lymph node biopsy because of damage to the tube caused by the puncture needle (n=1). Conclusion. All cases of breakage occurred secondary to technical factors owing to a lack of understanding of the structure of the bronchoscope and procedural instability. Bronchoscope damage increases expenses and procedural time while potentially reducing safety. The bronchoscopy procedure must be improved. Furthermore, practitioners should increase their understanding of the bronchoscope structure in order to prevent damage. Precautionary measures can be communicated through short lecture courses and education programs in order to increase practitioners' understanding of the internal structure of the bronchoscope and measures to increase procedural stability.</p>

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