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The diagnosis of traumatic transection of main bronchus is often delayed, resulting in attempts at surgical repair sometimes even months after the injury. Our aim is to analyze the factors affecting surgical outcome in patients undergoing lung preserving bronchial re-implantation for bronchial transection.

This is a retrospective analysis of prospectively maintained data of 10 cases of traumatic transection of main bronchus who underwent bronchial re-implantation at a tertiary thoracic surgery center in India. Patients were divided into two groups based on their total length of hospital stay. Occurrence of postoperative complications and/or hospital stay >7 days were considered poor surgical outcomes.

Out of 10 patients, 6 were left main bronchus transections and 4 right main bronchus transections. The male-female ratio was 73. Right-sided bronchial injury and higher preoperative Injury Severity Score (ISS) were associated with poor surgical outcomes (P < 0.01). These patients also had significantly higher anastomotic complications, chest tube duration, and prolonged postoperative air leak. Age of the patient, preoperative hemoglobin or albumin levels, and time of referral did not influence the surgical outcomes.

Poorer surgical outcomes were observed in patients who had right-sided main bronchus injury and higher ISSs. Time of referral did not influence the outcome. This study is limited by small sample size and retrospective nature. As no single center will have large numbers of this uncommon injury, multicenter pooled data are needed to re-affirm the findings of this study.

Poorer surgical outcomes were observed in patients who had right-sided main bronchus injury and higher ISSs. Time of referral did not influence the outcome. This study is limited by small sample size and retrospective nature. As no single center will have large numbers of this uncommon injury, multicenter pooled data are needed to re-affirm the findings of this study.

Diagnosis of isolated mediastinal tuberculosis (TB) can be challenging. Endobronchial ultrasound (EBUS) increases the diagnostic yield by direct sonographic visualization of mediastinal and hilar lymph nodes. With the advent of molecular techniques such as Gene Xpert, their addition to the cytology and cultures increases the diagnostic yield and detection of rifampicin resistance (RR) which helps change the effective therapeutic regimen immediately.

Prospective analysis of all patients undergoing EBUS-guided transbronchial needle aspiration (EBUS-TBNA) with a clinical possibility of TB in isolated mediastinal lymphadenopathy patients at a tertiary care referral center between June 2016 and January 2018. All patients had at least five passes from each node of which two passes from each lymph node sampled in 2 ml of saline for culture and Gene Xpert for microbiologic, pathologic, and molecular analysis as per hospital protocol.

Out of 60 patients, 44 were diagnosed to have mediastinal tuberculous lymphadel nodal aspirates traditionally believed to be paucibacillary can still be captured by Gene Xpert.

EBUS-TBNA is an effective and safe diagnostic tool for intrathoracic TB, especially for mediastinal tuberculous lymphadenitis. find more The combination of various tests increases the diagnostic yield. Mediastinal nodal aspirates traditionally believed to be paucibacillary can still be captured by Gene Xpert.

Postinfectious bronchiolitis obliterans (PIBO) is an uncommon and severe form of chronic obstructive lung disease in children. Adenovirus (ADV) is the main pathogen of PIBO in children. However, the risk factors of ADV-PIBO are not fully understood. This study aims to analyze the clinical characteristics of PIBO caused by ADV and compared with non-ADV-PIBO.

A retrospective study of children under the age of 14 years diagnosed PIBO was performed in 56 ADV-PIBO cases, 29 non-ADV-PIBO, and 39 healthy controls to determine clinical characteristics of PIBO.

There was no difference between ADV-PIBO and non-ADV-PIBO cases in gender, age, individual and family atopy or history of asthma, and previous history of wheezing and no difference in the clinical manifestations and signs between the two groups. However, the hospital stay, duration of ventilator use, and multifocal pneumonia incidence of ADV-PIBO group have a significant differences compared with non-ADV-PIBO. Notably, inflammatory markers lactic dehydrogenase (LDH), interleukin 8 (IL-8), and interferon-gamma (IFN-γ) were significantly increased in PIBO patients, and those expressed in ADV-PIBO patients were higher than those in non-ADV-PIBO patients. In addition, ADV-PIBO children required a longer duration of oral prednisone and azithromycin than non-ADV-PIBO cases.

Compared with non-ADV-PIBO, ADV-PIBO has a longer hospital stay, longer duration of ventilator use, increased LDH, IL-8, and IFN-γ expressions, and longer duration of oral prednisone and azithromycin treatment. Further research is needed to determine why PIBO caused by ADVs are more severe than those caused by other pathogens.

Compared with non-ADV-PIBO, ADV-PIBO has a longer hospital stay, longer duration of ventilator use, increased LDH, IL-8, and IFN-γ expressions, and longer duration of oral prednisone and azithromycin treatment. Further research is needed to determine why PIBO caused by ADVs are more severe than those caused by other pathogens.

Intubation with either an endotracheal tube or a rigid bronchoscope is generally preferred to provide airway protection as well as to manage unpredictable complications during transbronchial lung cryobiopsy (TBLC). The laryngeal mask airway has been described as a safe and convenient tool for airway control during bronchoscopy.

In this study, we evaluated the safety and outcome of using a laryngeal mask airway (LMA) as a conduit for performing TBLC by flexible video bronchoscopy (FB).

We retrospectively analyzed the database of the patients who underwent TBLC between November 2015 and September 2019. The procedure was performed using FB through LMA under general anesthesia. Prophylactic occlusion balloon was routinely used starting January 2017 onwards. Radial endobronchial ultrasound (R-EBUS) guidance was used for TBLC in the localized lung lesions when deemed necessary. Multidisciplinary consensus diagnostic yield was determined and periprocedural complications were recorded.

A total of 326 patients were analysed.