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Vol. 34. Issue 4.
Pages 207-220 (April 1998)
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Vol. 34. Issue 4.
Pages 207-220 (April 1998)
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Normas de consenso para la realización de la endoscopia respiratoria de la Sociedad Argentina de Broncoesofagología
Consensual guidelines for respiratory endoscopy from the Argentine Bronchoesophagology Society
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S. Quadrelli*, P. Grynblat, H. Defranchi, D. Downey, A. de la Canal, R. Perrone, A. Schiaffini Mauro
Grupo Argentino de Consenso para la Normatización de la Endoscopia Respiratoria. Sociedad Argentina de Broncoesofagología. Buenos Aires. Argentina
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Ha sido reconocido internacionalmente que no existe una normativa adecuada de los requerimientos institucionales, los beneficios, riesgos y limitaciones de la endoscopia respiratoria y los mecanismos de formación y acreditación del endoscopista haciendo que la forma de realizar el estudio dependa enteramente del entrenamiento recibido por cada operador. Esta ausencia de recomendaciones precisas genera una práctica muy diversa y aumenta el uso inapropiado de un procedimiento. El Grupo Argentino de Consenso para la Normalización de la Endoscopia Respiratoria (GACER) fue creado en 1995 para uniformar criterios respecto de varios puntos de la práctica endoscópica. Las recomendaciones oficiales del GACER y la Sociedad Argentina de Broncoesofagología delimitan las indicaciones (diagnósticas, terapéuticas y de investigación) y contraindicaciones (absolutas, relativas y condiciones de alto riesgo) de la broncoscopia. Se definen los estudios necesarios prebroncoscopia en condiciones de rutina y en situaciones especiales, las indicaciones de premedicación, intubación y anestesia general. Se puntualizan los requisitos del lugar de trabajo, del personal de apoyo y del instrumental requerido. Se sugieren normas para la anestesia tópica y las técnicas de inserción del endoscopio. Se define la técnica, indicaciones y limitaciones del BAL, cepillado bronquial y biopsia y punción transbronquial. Se definen la utilidad y limitaciones de las distintas técnicas de broncoscopia terapéutica (láser, radioterapia y prótesis intraluminales). Se enfatizan las normas de bioseguridad para el paciente, el instrumental y los operadores.

Palabras clave:
Broncoscopia
Biopsia broncoscópica
Lavado broncoalveolar
Láser
Prótesis endotraqueales

The international consensus is that guidelines for respiratory endoscopy are inadequate, regarding such issues as intitutional requirements, benefits, risks and limitations of the procedure, training programs and accreditation, with the result that the way of performing endoscopy varies acording to how an operator was trained. The absence of precise recommendations means that practice is highiy diverse and inappropriate use of the procedure has increased. The Argentine Consensus Group for Normalization of Respiratory Endoscopy was created in 1995 to unify criteria for several aspects of endoscopic practice. The official recommendations of the Group and of the Argentine Society of Bronchoesophagology define the indications (diagnostic, therapeutic and investigative) and contraindications (absolute, relative and high risk) for bronchoscopy. Required pre-bronchoscopic studies for routine and special cases are defined, as are indications for premedication, intubation and general anesthesia. Requirements for the setting, support personal and instruments are specified. Guidelines for topical anesthesia and techniques for insertion of the endoscope are suggested. The technique, indications and limitations of bronchoalveolar lavage, bronchial brushing and biopsy and transbronchial needle biopsy are defined. The utility and limitations of the various therapeutic techniques of bronchoscopy (laser, radiotherapy and stents) are defined. Norms to safeguard the patient, instruments and operator are emphasized.

Key words:
Bronchoscopy
Bronchoscopic biopsy
Bronchoalveolar lavage
Laser
Endotracheal prostheses
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