Indications and outcome of bronchoscopy in Bronchoscopy Unit, Chest Department, Ain Shams University Hospital: a 6-month report

Abstract

Background Bronchoscopy is a well-established maneuver in pulmonary medicine. It is an important method in the diagnosis, staging, and treatment of lung cancer and other pulmonary diseases. Various diagnostic techniques such as bronchial biopsy, bronchial washing and brushing, and transbronchial lung biopsy are used during fiberoptic bronchoscopy to increase the diagnostic yield of the procedure. Rigid and fibreoptic bronchoscopes remain complementary techniques, and are usually used concurrently during many procedures. Aim The aim of this study was to study the indications and outcome of bronchoscopic workup in the Bronchoscopy Unit, Chest Department, Ain Shams University Hospital in the period from May 2013 to October 2013. Patients and methods All patients undergoing either fiberoptic bronchoscopy or rigid bronchoscopy were subjected to full history and clinical examination, and monitored regarding their preprocedure investigations, procedure details and sampling techniques, postprocedure complications, and finally the patients were followed up regarding their histopathological and bacteriological results. Results One hundred cases were monitored, 65 male patients and 35 female patients. The mean age of the patients was 50.92±20.099 years. Fifty-six patients were smokers, whereas 44 patients were nonsmokers. The most frequent presenting symptom was dyspnea in 50% of cases, followed by hemoptysis in 27% of cases. Adenocarcinoma was diagnosed in seven patients, squamous cell carcinoma was diagnosed in six patients, small-cell lung cancer was diagnosed in four patients, and large-cell lung cancer was diagnosed in three patients. In 15 (40.54%) cases, the histopathological results were inflammatory, nonconclusive to malignancy. All patients with lung cancer showed radiological abnormalities. Two cases were diagnosed as TB in spite of their workup of TB such as tuberculin test and sputum Z&N being negative. There were no mortalities. There was no bronchoscopy-related complications in 85% of cases, whereas four (4%) cases suffered bleeding during biopsy and debulking of the tumor, which was controlled by local hemostatic measures In eight (8%) cases most of whom were smokers, suffered desaturation, due to prolonged time of the procedure. They were not hypoxic before the beginning of bronchoscopy. Only two (2%) cases were mechanically ventilated due to bleeding and hypoxia during and/or after the procedure, and one case had surgical emphysema, which was managed conservatively. Conclusion Bronchoscope is a very effective and safe procedure; safety and effectiveness obviously depend on the accuracy of selection of the patients for the procedure, the experience of the bronchoscopist, and on the facilities available. Proper use of diagnostic techniques provides a high degree of success, and the treatment modality to be used depending on the type of the lesion is mostly satisfactory.

Keywords

• aspergillosis
• bronchopulmonary
• miliary tuberculosis