title: Changing patterns in interventional bronchoscopy.
abstract: OBJECTIVE
  Many interventional tools for airway disorders can now be delivered via flexible bronchoscopy (FB), including neodymium-yttrium aluminium garnet laser, electrocautery, argon plasma coagulation, cryotherapy, balloon dilatation and metal or hybrid stents. Comparison of outcomes for patients undergoing rigid bronchoscopy (RB) with those treated using FB highlights the usefulness of the FB approach.
  
  
  METHODS
  A retrospective medical record review of all interventional bronchoscopy procedures performed at Lahey Clinic over the past 8 years was conducted. Patients were categorized into two groups according to the procedure used, that is, RB (251 patients), and FB (161 patients) groups. Patients with malignancies were included as a separate subgroup, comprising 178 RB and 117 FB patients. For every procedure, the location of the lesion, patient survival from the first interventional procedure performed, and in patients with malignancy, additional treatments received such as chemotherapy and radiation were recorded.
  
  
  RESULTS
  Ninety per cent of RB procedures were performed in patients with tracheal or main stem lesions, while over half the patients undergoing FB had more distal lesions. A trend towards increasing use of FB for interventional procedures in recent years was noted.
  
  
  CONCLUSIONS
  FB is a valuable alternative to RB for treating less advanced malignant disease or distal airway lesions.
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Lahey Clinic Medical Center, Tufts University School of Medicine, Burlington, Massachusetts 01803, USA.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Zias
authors.forename: Alexandra
authors.initials: A
authors.lastname: Chroneou
authors.forename: Anne V
authors.initials: AV
authors.lastname: Gonzalez
authors.forename: Anthony W
authors.initials: AW
authors.lastname: Gray
authors.forename: Carla R
authors.initials: CR
authors.lastname: Lamb
authors.forename: David R
authors.initials: DR
authors.lastname: Riker
authors.forename: John F
authors.initials: JF
authors.lastname: Beamis
mesh_terms: D000368:Aged; D001982:Bronchial Diseases / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D020680:Bronchoscopes; D001999:Bronchoscopy; D015331:Cohort Studies; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016019:Survival Analysis; D014133:Tracheal Diseases / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome