Bronchoscopies interventionnelles en urgence

An emergency interventional endoscopic procedure is often the only way to overcome an asphyxic or pre-asphyxic situation. From November 1978 to June 2010 we performed 9950 interventional endoscopies among which 20% were performed in an emergency context. To obtain a homogeneous study group, we reviewed the last four years. 344 interventional emergency endoscopies were done for the following indications: cancers (n = 240, 70%), iatrogenic stenosis (n = 63, 18%), foreign bodies (n = 29, 8.5%), hemoptysis (12, 3.5%). The same technique was used in all cases: operating room, general anesthesia, rigid bronchoscope, laser, cryotherapy. Outcome was favorable in 85% of cancers and 100% in all other indications. Apart from clear-cut cases, it remains difficult to define the true emergency. Whatever the definition retained, a well-trained anesthetic and endoscopic team is crucial for proper intervention in these potentially life-threatening situations.