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Temos

  • PULMONOLOGY
  • PULMONOLOGY
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PULMONOLOGY

Metropolitan Hospital operates a model, fully equipped and organized Pulmonary Clinic. With leading scientific and nursing staff and state-of-the-art equipment, the Pulmonary Clinic comprehensively treats every disorder or problem of the respiratory system and is available to patients 24/7.

Leading Scientific Staff

Our fully qualified pulmonologists and nursing staff, who have been trained abroad, offer all the diagnostic and therapeutic services, while ensuring ideal inpatient conditions and assistance to patients. We are able to treat all patients regardless of the pulmonary disease.

There are special asthma, sleep disorder, sarcoidosis and diffuse lung disease departments. We have placed great emphasis on Pulmonary Oncology and environmental pulmonary diseases. A Smoking Cessation Clinic also operates as part of the Pulmonary Clinic.

There is close collaboration with the Intensive Care Unit for the hospitalization of patients with severe respiratory problems and subsequent monitoring and hospitalization in a High Dependency Unit (HDU).

State-of-the-Art Technology

The Pulmonary Clinic labs are equipped with state-of-the-art equipment and perform pulmonary function tests and sleep studies, while the fully-equipped Bronchial Lab offers all pulmonary techniques.

Model Labs

At the Pulmonary Endoscopy Lab, the equipment, methods and lab techniques provide doctors with a full understanding of the state of the lungs, and the ability to collect bronchoalveolar lavage and perform a transbronchial biopsy. They are also able to use endobronchial ultrasound for the examination of the mediastinum and the lymph nodes.

All tests that examine respiratory function are performed at the Pulmonary Function Lab. These tests include spirometry, which is recommended for individuals with chronic respiratory problems and smokers, and lung plethysmography, which is used for comprehensive understanding of a patient’s condition.

BRONCHOSCOPY

BRONCHOSCOPY

Bronchoscopy (or inspection or endoscopy of the bronchial tree) is a widely used application for the detection/diagnosis and treatment of many lung diseases. The diagnostic and therapeutic applications of these simple methods are broadly used in modern medical practice.

Background:

In the late 1890s, Gustav Killian managed to inspect the trachea and remove a foreign object that had been wedged into the right bronchial tree by using a laryngoscope-type instrument. It was the first bronchoscopy and Killian was named the father of bronchoscopy. In 1904, Jackson invented the rigid bronchoscope, while in 1968 Oleda introduced the fiberoptic bronchoscope (flexible bronchoscope). Video bronchoscopy is being used since 1987. In recent years, with the development and application of innovative techniques (endobronchial ultrasound, laser, diathermy, cryotherapy and more), modern technology has made bronchoscopy an extremely valuable tool in the diagnosis and treatment of many lung diseases.

How is bronchoscopy performed?

As mentioned earlier, it is a simple and painless procedure. It is performed in the endoscopy laboratory. The patient is injected with local and twilight anesthesia. The bronchoscope may be inserted either via the nose or mouth. The actual time of the bronchoscopy procedure (i.e. the bronchoscope’s entry/exit) does not exceed 10-30 minutes. Hospitalization is not required and the patient can go home 1 hour after the procedure.

Why is a bronchoscopy performed?

There are many mainly diagnostic reasons (indications) related to various symptoms or abnormal lab tests which would deem a bronchoscopy necessary. It is also useful during the staging, monitoring and treatment of various diseases.

There are few contraindications and complications.

Specifically:

DIAGNOSTIC

INDICATIONS

A. Indications that are associated with symptoms, history and clinical exam:

  • Chronic cough
  • Blood in sputum
  • Wheezing (especially localized)
  • Stridor
  • Hoarseness (vocal cord dysfunction/paresis/paralysis)
  • Chest pain
  • Abdominal pain syndrome
  • Aspiration (gastric content / foreign body)
  • Chest injury
  • Chemical or thermal injury of tracheobronchial tree

B. Indications associated with abnormal lab tests

  • Positive or suspicious saliva gland cytology
  • Abnormal chest X-ray
    • Diaphragmatic paralysis
    • Mediastinal and hilar lymphadenopathy
    • Atelectasis
    • Undiagnosed pleural effusion
    • Cavitis
    • Slow resolving pneumonia
    • Persistent pneumothorax
    • Benign & malignant tumors
    • Infections
    • Diffused parenchymal diseases

C. Indications that are associated with known lung diseases

  • Diagnosis and staging of bronchogenic carcinoma
  • Investigation of therapeutic result of various diseases (cancer, interstitial lung diseases)

OTHER INDICATIONS

  • Tracheal intubation
  • Investigation of endotracheal tube
  • Bronchography
  • Lavage (bronchoalveolar lavage) (interstitial lung diseases)

THERAPEUTIC

  • Lavage for:
    1. Pulmonary alveolar proteinosis
    2. Secretion retention
    3. Mucus plug
    4. Blood clots (thrombi)
  • Removal of foreign body
  • Control of hemorrhage
  • Control/drainage of lung abscess
  • Closing of bronchocostal, tracheoesophageal & bronchoesophageal fistula
  • Placement of tracheal/bronchial stents
  • Brachytherapy, laser, diathermy, cryotherapy for the treatment of benign & malignant lung tumors

Nikos D. Chainis, MD, FCCP
Pulmonology Clinic Director

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SEE ALSO

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