Anesthesia for Pediatric Rigid Bronchoscopy and Related Airway Surgery: Tips and Tricks

This book is a resource on projection systems for any music teacher’s treasure chest of tools. Educators, from brand new to seasoned veterans, can discover new lessons, activities, and resources involving the projection systems already in their classrooms. From conventional projectors to streaming media players, beginners to the digital world will find tips and tricks to start using new systems. More experienced users will discover new resources and activities, from learning how to create VR worlds to demonstrate knowledge of music venues from around the world, to going on an outside safari to find missing instruments of the orchestra. This book also includes a resource index with app and website recommendations for going further and appendices that make it easier to find the activities and resources to fit any type of instruction. This book is a toolbox for teachers to keep on their desks to use every day to incorporate their digital tools in a meaningful way.

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Clinical analysis of tracheobronchial foreign body aspiration in children: a focus on external and intrinsic factors

BMC Surgery ◽

10.1186/s12893-021-01089-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Weigang Gan ◽

Ning Xiao ◽

Yiyuan Feng ◽

Danmei Zhou ◽

Juanjuan Hu ◽

...

Keyword(s):

Foreign Body ◽

Pediatric Patients ◽

Treatment Delay ◽

Rigid Bronchoscopy ◽

Foreign Body Aspiration ◽

External Factors ◽

Factors Affecting ◽

Intrinsic Factors ◽

Common Location ◽

Tracheobronchial Foreign Body

Abstract Background Tracheobronchial foreign body aspiration (TFBA) is a critical disease in children and is extremely dangerous, even life-threatening. The factors affecting the occurrence and prognosis of TFBA are complex. The purpose of this study is to examine the external and intrinsic factors affecting clinical features of TFBA in West China and propose potential effective intervention measures. Methods We retrospectively analyzed the clinical data of pediatric patients diagnosed with TFBA with foreign bodies (FBs) removed by rigid bronchoscopy under general anesthesia at the otolaryngology department from December 2017 to November 2018. The data included age, sex, clinical symptoms, type and location of FB, guardians, prehospital duration and residence of these pediatric patients. Results The ratio of males (72) to females (53) was 1.4:1. Children aged from 1 to 3 years accounted for 76% (95/125) of patients. Cough, continuous fever and dyspnea were the primary symptoms. The right primary bronchus was the most common location of FB detection by rigid bronchoscopy (67 cases, 53.6%). Organic FBs were most common in our study. Guardians of patients significantly differed in the rural (parents 16, grandparents 31) and urban (parents 52, grandparents 26) groups (χ2 = 12.583, p = 0.000). More children in the rural group than in the urban group had a treatment delay longer than 72 h. More children in the group with no history of FB aspiration (12, 25%) than in the group with prior FB aspiration had a treatment delay longer than 72 h. Conclusion Pediatric TFBA is a common emergency in otolaryngology. Age, sex, tracheobronchial anatomy and other physiological elements were defined as intrinsic factors, while guardians, residence, FB species and prehospital time were defined as external factors of TFBA. External and intrinsic factors both influence the occurrence and progression of TFBA. It is extremely important to take effective measures to control external factors, which can decrease morbidity and mortality.

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Use of an Insulation-Tipped Knife during Rigid Bronchoscopic Treatment of Benign Tracheobronchial Stenosis

Medicina ◽

10.3390/medicina57030251 ◽

2021 ◽

Vol 57 (3) ◽

pp. 251

Author(s):

Ji-Won Park ◽

Yousang Ko ◽

Changhwan Kim

Keyword(s):

Tracheal Stenosis ◽

Treatment Success ◽

Stable State ◽

Forced Expiratory Volume ◽

Rigid Bronchoscopy ◽

Bronchial Stenosis ◽

Tracheobronchial Stenosis ◽

Acute Complications ◽

The Mean ◽

Post Intubation

Background and Objectives: Tracheal or bronchial tears are potential complications of rigid bronchoscopy. This study aimed to investigate the acute complications and outcomes of using an insulation-tipped (IT) knife in combination with rigid bronchoscopic dilatation for treating benign tracheobronchial stenosis. Materials and Methods: We conducted a chart review of patients with benign tracheobronchial stenosis who were treated with rigid bronchoscopy and an IT knife at two referral centers. Treatment success was defined as a clinically stable state without worsening symptoms after 3 months of treatment. Results: Of the 23 patients with benign tracheobronchial stenosis, 15 had tracheal stenosis and 6 had main bronchial stenosis. Among them, three cases were of simple stenosis (13%), while the others were of complex stenosis (87%). The overall treatment success rate was 87.0%. Pneumomediastinum and subcutaneous emphysema occurred due to bronchial laceration in two cases of distal left main bronchial stenosis (8.7%), and no other significant acute complications developed. Silicone stents were inserted in 20 patients, and successful stent removal was possible in 11 patients (55.0%). Six of the seven stents inserted in patients with post-intubation tracheal stenosis were removed successfully (85.7%). However, most of the patients with post-tracheostomy tracheal stenosis required persistent stenting (80%). Pulmonary function was significantly increased after treatment, and the mean increase in the forced expiratory volume in 1 s was 391 ± 171 mL (160–700 mL). Conclusion: The use of an IT knife can be suggested as an effective and safe modality for rigid bronchoscopic treatment of benign tracheobronchial stenosis.

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Laparoscopic resection of rectovaginal endometriosis involving segmental bowel resection and anastomosis: pre‐operative planning, intra‐operative decision making, description of technique, and tips and tricks for a successful outcome.

Colorectal Disease ◽

10.1111/codi.15737 ◽

2021 ◽

Author(s):

T Bainton ◽

V Celentano ◽

J Phillips ◽

O Warren ◽

R Richardson ◽

...

Keyword(s):

Decision Making ◽

Laparoscopic Resection ◽

Bowel Resection ◽

Successful Outcome ◽

Tips And Tricks ◽

Rectovaginal Endometriosis ◽

Segmental Bowel Resection ◽

Operative Planning ◽

Resection And Anastomosis

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Different effects of bronchoscopic interventions on children and adults with tracheobronchial mucoepidermoid carcinoma

Tumori Journal ◽

10.1177/0300891621995898 ◽

2021 ◽

pp. 030089162199589

Author(s):

Zhang Jieli ◽

Zhou Yunzhi ◽

Zhang Nan ◽

Zou Heng ◽

Wang Hongwu ◽

...

Keyword(s):

Mucoepidermoid Carcinoma ◽

Argon Plasma Coagulation ◽

Survival Rates ◽

Argon Plasma ◽

Rigid Bronchoscopy ◽

Low Grade ◽

High Grade ◽

Adult Group ◽

Histologic Grading ◽

Comprehensive Therapy

Aims: To investigate the efficacy and safety of minimally invasive bronchoscopic interventions for patients with tracheobronchial mucoepidermoid carcinoma (MEC). Methods: Patients with tracheobronchial MEC were included in this retrospective study, and the clinical features, histologic grading, treatments, and cumulative survival rates were calculated. Patients were categorized into child (n = 16) and adult (n = 19) group according to their ages. Histologic grading, treatments, and survival status were compared between the two groups. Results: In pathology, high-grade MEC counts for 6.77% and 42.10% in the child and adult group, respectively. As tumor growth pattern was concerned, 93.33% and 21.05% tumors in the child and adult group present intratracheal type. Multiple bronchoscopic interventions were conducted, including rigid bronchoscopy, argon plasma coagulation (APC), dioxide carbon cryotherapy, and electric loop. Tumors could be removed by multiple bronchoscopic interventions. Bronchoscopy-associated complications were rare, including an oral mucosa injury and a glottis edema. In the child group, one patient underwent left upper lung lobectomy. In the adult group, lobectomy and/or chemotherapy and/or radiotherapy were conducted in seven patients. The 5-year survival rate was 100% and 68.90% in the child and the adult group, respectively. Conclusions: Almost all children have low-grade and intratracheal MEC; 2/5 adults have invasive high-grade MEC. Multiple bronchoscopic interventions are effective in erasing low-grade intratracheal MEC without severe complications. For high-grade invasive MEC, aggressive and comprehensive therapy should be considered.

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