Interventional Bronchoscopy

The rapidly emerging field of interventional bronchoscopy adds dimension to the therapeutic armamentarium of lung cancer. Treatment of central airway obstruction is, however, just a small part of this book, which aims to cover all aspects of modern diagnostic and therapeutic interventional bronchoscopy and to promote progress in respiratory research. It also includes some techniques which are still at an investigational stage. Parallel to the development of ever-finer flexible bronchoscopes and working tools, advances in imaging techniques of the organs of the chest have become essential for localization and identification of structures such as lymph nodes, tumours adjacent to bronchial walls, cysts and so on, which can be assessed endoscopically to an extent physicians a mere generation ago would not have thought possible. Apart from this development with the flexible instrument, therapeutic bronchoscopy has come of age, with procedures such as laser resection, electrocautery, argon plasma coagulation, cryotherapy, brachytherapy, photodynamic therapy and stenting, which have all become recognized treatment modalities. The term ''interventional bronchoscopy'' encompasses all of these techniques, the use of both flexible and rigid instruments and diagnostic as well as therapeutic procedures which go beyond simple bronchoscopy. This text brings together leading interventional bronchoscopists and their knowledge, and serves as both a textbook and reader on developments in the field. It begins with a historical introduction to bronchoscopy, and then goes on to discuss all topics mentioned above and emerging areas such as fluorescence bronchoscopy for the early detection of lung cancer, endobronchial ultrasound, optical diagnostic and therapeutic technologies, virtual bronchoscopy and endobronchial gene therapy. Further chapters examine the role of bronchoscopy as an integral part of a patient's management. In all, the book aims to present a study of bronchoscopy from Killian, over a century ago, to the most modern concept of endoscopic gene therapy for pulmonary neoplasms.