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Abstract
The major advances in interventional pulmonology are attributed to improvement in bronchoscopy itself, and more importantly to great scientific revolution in laser therapy , PDT, etc.
Therapeutic bronchoscopy has a great role in different chest diseases as:
1. Airway diseases:
a) Upper and central airway diseases:
Foreign body aspiration, post intubation stenosis, tracheomalacia, central airway tumors , placement and replacement of endotracheal tube.
b) Lower airway diseases:
Cure for in situ and early lung cancer, recanalization and debulking of inoperable malignancies, management of massive hemoptysis, management of broncholithiasis, resection of benign tumors, foreign body removal, thermoplasty in bronchial asthma, endobronchial lung volume reduction surgery in cases of emphysema (either with one way valve or by using sclerosing agents), cases of endobronchial tuberculosis and its sequelae, and bronchopleural fistula.
2. Parenchymal lung diseases:
In cases of sarcoidosis, pulmonary alveolar proteinosis and in drainage of lung abscess.
3. Mediastinal lesions:
It may be used in evacuation of mediastinal cysts avoiding the need for surgery.
Although therapeutic bronchoscopy can be used successfully in the above mentioned great and critical indications , it still earns new lands and new roles in interventional medicine. It has few disadvantages and contraindications.