An experience of syndrome diagnostics of respiratory diseases in a radiological-and-bronchological room

Abstract

A radiological-and-bronchological room at the Republican clinical hospital was opened 18 years ago. The last 10 years when fibrobronchoscopy has become available we performed bronchological examination for 14,646 patients: 1003 of them received therapeutic peripheral bronchial catheterization, bronchographic procedure under a local anesthesia was made in 6819 patients and that under narcosis was done in 372 patients. Based on this experience we concluded that morphological validation of pulmonary diagnosis should become an inalienable part of the diagnostic work-up. The bronchoscopy should be available and be included into a necessary clinical examination of a pulmonary patient. This allows not only detection of malignant lesions but also revelation of respiratory tuberculosis more often than in a specialized institution. Besides the bronchoscopic rooms, organization of régional radiological-and-bronchological centres or rooms based on several régional hospitals is reasonable. If a doctor is informed of médical facilities' equipment and indications for an invasive diagnostic method and is aware of a danger of long-term observation of patients with uncertain diagnosis and test therapy he can create the optimal and economically bénéficiai diagnostic algorithm for any patient.