Kenichi Takino

The Actual State of Medical Service Provided at the Department of Bronchoesophagology of Our Hospital

As one of the specialties in a general hospital, the clinical procedures performed in our clinic are carried out in close collaboration and cooperation with the other services in our hospital, especially the departments of internal medicine, respiratory diseases, thorasic surgery and radiology. To appreciate the actual scope of the medical service rendered in the department of bronchoesophagology in a general hospital, a review of the patients managed in our clinic during a recent two-year-period (from August, 1956 to July, 1958) is presented and the role which should be assumed by the department of bronchoesophagology in a general hospital is discussed.The most frequent disorders which were encountered in our clinic were pulmonary tuberculosis, hemoptysis, suppurative diseases of the lung, lung tumors and foreign bodies. The procedures performed in patients with the these disorders were bronchoscopic and esophagoscopic examinations, bronchography endoscopic irrigation and medication, suction of secretions, removal of foreign bodies in the bronchus or esophagus, biopsies, bronchospirometric studies, etc.During this two-year period 1073 procedures were carried out. Approximately twothirds of the total number were for diagnostic purposes and the remaining one-third therapeutic procedures. The therapeutic procedures consisted mainly of endoscopic irrigation and medication in patients with pulmonary tuberculosis or suppurative diseases of the lungs (24%), and only 3.8% or 19 of 491 endoscopic exminations were performed to remove foreign bodies from the bronchus or esophagus.As the figures in this study show, the clinical procedures rendered in the bronchoesophagolog ical department are mainly diagnostic in nature. Moreover, it was clearly demonstrated that active performance of endoscopic examinations in many patients for diagnostic purposes in cooperation with the related specialties was of value in early detection of diseases and in establishing early diagnosis and course of treatment, thus contributing not a little to the overall medical care of patients in a general hospital.It is the authors opinion that this is the most important function of the department of bronchoesophagoloy in a general hospital and it is emphasized that the active and early use of endoscopic examination should be adopted so that it can be performed as readily and easily as other routine clinical methods of investigation.