Diagnosis of fibrosing tracheobronchopathy in Specialized Pulmonary Clinic Asklepios Munich-Gauting

About the department

The Department of Pulmonology at the Specialized Pulmonary Clinic Asklepios Munich-Gauting provides the full range of diagnostic and therapeutic services to patients with diseases of the lungs, respiratory tract, and other chest organs. The department is one of the largest specialized medical facilities of this kind in Germany. The exceptional professionalism and long experience of the department's doctors allow for comprehensive treatment adapted to the patient's needs. The priority focuses of the department's work are the treatment of interstitial lung disease, pneumonia, chronic obstructive pulmonary disease, cancer, tuberculosis, and other pulmonary diseases. The department's doctors also have vast experience in providing medical care for patients with rare lung diseases. In the case of unclear or particularly complex pathologies, accurate differential diagnostics are carried out. The department has state-of-the-art equipment for diagnostic and therapeutic bronchoscopic procedures. Bronchoscopy is performed in the most comfortable conditions and is absolutely painless. The department's pulmonologists cooperate closely with thoracic surgeons, oncologists, and radiologists. The Head Physician of the department is Dr. med. Wolfgang Gesierich.

The department has excellent technical resources for bronchoscopy. The procedure can be performed for both diagnostic and therapeutic purposes. When performing bronchoscopy, doctors can visually assess the condition of the upper and lower respiratory tracts, and if pathological changes are detected, they often immediately perform the necessary therapeutic manipulations. The procedure requires a special instrument in the form of a thin tube (a bronchoscope), which is equipped with a camera, light, and manipulators. The bronchoscope is inserted through the patient's nose or mouth and then advanced through the throat into the lungs. High-resolution images are continuously displayed on a large screen. The procedure is performed under local or general anesthesia, so any pain is excluded.

The most common indications for diagnostic bronchoscopy are suspected tumors of the lungs and other chest organs, suspected airway stenosis or obstruction, chronic lung infections, chronic obstructive pulmonary disease, and other pathological conditions. For example, if a small neoplasm is detected in the lungs, the department's doctors immediately remove it endoscopically, which allows the patient to avoid traumatic classical surgery. In addition, large neoplasms in the chest organs often cause airway stenosis, as a result of which a patient develops severe shortness of breath and difficulty breathing. In such cases, the department's pulmonologists may perform endoscopic stent implantation. This is a procedure during which a stent (a structure resembling a frame) made of silicone or nitinol is placed in the narrowed area, which eliminates stenosis and ensures normal airway patency.

The department's team of doctors offers patients a modern method of endobronchial cryotherapy, which helps get rid of neoplasms in the lungs without any surgery. During the procedure, a special cryoprobe is used, which is inserted through a flexible or rigid bronchoscope. The specialist either affects the tumor superficially or carefully inserts the probe into the tumor. The probe destroys the tumor in a few minutes by cooling to a temperature of about -80 °C. At the end of the procedure, the bronchoscope is removed along with the cryoprobe and the remnants of the tumor or part of it (in the case of very large tumors). The cryotherapy method demonstrates high effectiveness, while bleeding is the only potentially serious complication of the procedure. The department's specialists accurately monitor the patient's condition after the procedure, and if any bleeding develops, they conduct drug therapy or argon plasma coagulation.

The department's therapeutic options also include the treatment of severe forms of pulmonary emphysema using endoscopic lung volume reduction. During the procedure, special spirals are implanted in the pathological foci, due to which the affected tissues atrophy and the healthy ones grow. Thus, the patient's lung function improves, and he can breathe normally. The department also uses the technique of endoscopic lung volume reduction using water vapor. The therapeutic effect is achieved due to the controlled introduction of water vapor through the catheter into the areas of the lungs affected by emphysema, which eventually leads to scarring and their volume reduction. Each of these methods has its own characteristics, so the department's doctors select the appropriate procedures on an individual basis.

The department specializes in the treatment of the following pulmonary diseases:

• Benign and malignant tumors of the lungs and other chest organs
• Chronic obstructive pulmonary disease
• Interstitial lung disease
• Pulmonary sarcoidosis
• Pulmonary hypertension
• Pneumonia
• Coronavirus infection
• Tuberculosis
• Rare lung diseases
• Other pathologies

The department's range of therapeutic services includes:

• Drug therapy: intake of pills, infusions, and injections
• Inhalation therapy
• Artificial lung ventilation
• Endoscopic therapeutic procedures
  • Laser therapy
  • Cryotherapy
  • Argon plasma coagulation
  • Photodynamic therapy
  • Airway stenting
  • Removal of foreign bodies from the respiratory tract
  • Endobronchial hemostasis
  • Endoscopic lung volume reduction
• Other treatment methods