처음 진단된 식도암 환자에서 기관지 내시경 검사의 의의 및 적응증

Abstract

Objectives : To determine the yield of bronchos copy for evaluating trach eobronchial spread in esophageal carcinoma and to identify the conditions for bronchos copy in patients with newly diagnosed esophageal carcinoma, who planned to be operated. Methods : From March 1989 to June 1997, 115 patients with esophageal carcinoma had received bronchos copy. Bronchos copic findings were classified into three types : Type I : no definitive endobron chiallesion, Type II : indirect effects (hyperemia and compression), Type III : invasion. CT findings were classified into three classes : Class A : tumors eparated from tracheobronchialtree, Class B : a but ting tree, Class C : compressing tree . We investigated the correlations of c linical presentation and non-invasive tests (including esophagogram) with bronchos copicfindings. Results : 1) Among 115 patients, bronchos copic findings were Type I in 67( 58.3% ), Type II in 34( 29.6% ), Type III in 14( 12.2% ). 2) Abnormal bronchos copic findings are related with length of lesion by esophagogram .(p < 0.05) 3) Class C lesion by chest CT scan were closely correlated with abnormal bronchos copic findings. 4) Chest symptoms were frequently associated with type III lesion of bronchos copy Conclusion : We could recommend preoperative bronchos copy in recently diagnosed a sesophageal carcinoma who got more than 2 of 3 variables listed below : 1) patients who had chest symptoms , suchas cough withs putum, hemoptysis, and dyspnea 2) length of tum or is long in esophagogram(above 5 cm in length), 3) trach eobronchial compressed lesion by chest CT scan. Bronchos copy is not needed in cases with no chest symptom, short lesion length (below 5 cm) and normal chest CT finding for preopera tive evaluation of esophageal carcinoma.