Review of a 10-year experience of rigid bronchoscopy at a tertiary centre in Singapore

Abstract

Purpose No report of rigid bronchoscopy (RB) has been described from Singapore. Methods We did a retrospective review of medical records of patients undergoing RB between November 2009 and November 2019 at Tan Tock Seng Hospital. Results 135 patients underwent 203 RB. RB was done for malignant central airway obstruction (MCAO) in 91 and benign diseases in 44 patients. The techniques used were Nd: YAG laser (n= 56), stenting (n= 63), transbronchial needle aspiration (n= 5), clot removal (n= 9), ballooning (n= 15), argon plasma coagulation (n= 5), and electrocautery (n= 37). Procedural complications occurred in three (2.2%). Median survival was 10.1 months (interquartile range [IQR], 2.2 to 45.3) in the whole group, 7.8 (IQR, 2 to 18.3) in MCAO and 42.6 (IQR, 8.9 to 77.5) in benign diseases respectively. Twenty-two (16.3%) patients requiring intensive care unit survived for 7.1 months (IQR, 1.6 to 9.8) after RB. Twenty-eight (21%) patients required repeat RB 68 times. Of these 34 (50%) were for granulation tissue removal. Conclusion RB was safe and improved survival however, the demand was low. The most common indications were re-canalization of MCAO and granulation tissue removal. The later was the most resource consuming indication for repeat RB. Future research should focus on minimization of granulation tissue formation.

Keywords

• bronchoscopy
• central airway obstruction
• lasers
• lung neoplasms
• stents