Broncho-Esophagology

A Critical Review

Progress in any branch of medicine is dependant on contributions in other fields. In bronchoesophagology it is dependant on advances in anesthesiology, roentgenology and thoracic surgery and the influence of the antibiotics. Among the advances are:

1) The need for more endoscopic study of infants to detect congenital anomalies which now can be successfully treated surgically. In certain cases endoscopy is more important than roentgen study.

2) Tuberculous tracheobronchitis constitutes a problem. Bronchoscopy is invaluable in the diagnosis and studies have shown that it does not aggravate or increase the likelihood of spread. Streptomycin has aided immensely in the treatment of tuberculous tracheobronchitis. The concomitant parenteral and aerosal administration appears to give the best results. One gram parenterally and 0.5 grams by nebulization are given during a 24 hour period.

3) With lowering mortality rates following pneumonectomy the outlook in bronchogenic carcinoma should improve. Cytologic examination of bronchoscopically removed secretions or sputum have aided enormously and many cases with negative bronchoscopic findings now are diagnosed by cytology as carcinoma and treated successfully. Studies indicate that operability rates are higher in cases where bronchoscopy is negative and cytology is positive.

4) There is an increasing interest in hiatal hernia since many of these cases are not suitable for surgery and mechanical treatment is required. Recurring esophagitis is considered as a possible cause for the cicatrization and shortening of the esophagus in these cases.