1990 Volume 12 Issue 5 Pages 457-466
Tracheobronchial involvement of esophageal carcinoma was estimated in 40 patients by pre-operative fiberoptic bronchoscopy. Fiberoptic bronchoscopic findings were classified into four types by the grade of tracheobronchial involvement. In the first type, class (⫲), tumor protrusion into the tracheobronchial lumen was found. In the second type, class (+), bulging and other mucosal changes, such as hyperemia or granulation of the tracheobronchial wall were found. In the third type, class (±), either bulging or mucosal changes was found. In the fourth type, class (-), there were no abnormalities. We supposed that class (⫲) and class (+) show tracheobronchial invasion of esophageal carcinoma, and no invasion in class (±) and class (-). In 34 patients, who underwent operation, preoperative staging by computed tomography (CT) and fiberoptic bronchoscopic findings were correlated with surgical findings. Fiberoptic bronchoscopy correctly identified 15 of the 16 patients with tracheal invasion and 17 of the 18 patients without invasion (accuracy 94.1%). Fiberoptic bronchoscopy also correctly identified 12 of 14 patients with bronchial invasion and 15 of 20 patients without invasion (accuracy 79.4%). This result was equal to the results by CT staging. In the esophageal carcinoma patients with tracheobronchial involvement, fiberoptic bronchoscopy showed the degree of invasion. We confirm that pre-operative fiberoptic bronchoscopy is very important for the management of esophageal carcinoma patients with tracheobronchial involvement.
