Bronchoscopy, indications, safety and complications

OBJECTIVE: To review the safety, indications, complications of flexible fiberoptic bronchoscopies performed at university teaching hospital, and to correlate the bronchoscopic findings with radiology, histology, and history of smoking.

METHODS: A total of 124 consecutive flexible fiberoptic bronchoscopies were reviewed in the last 3 years. A special form that contains personal data, indications, premedications, route of insertion, bronchoscopic findings, and complications in subjects-undergone bronchoscopy was completed.

RESULTS: A suspicion of pulmonary tuberculosis (31%), lung mass (19%) and hemoptysis (18%) were the most common indications. Hypoxemia (14%) during procedure and pneumothorax post procedure were the most common complications. Mortality rate was 0%. For 57% of subjects who had histology, lung cancer (44%), and tuberculosis (15.5%) were commonly found. Lung cancer (72%) and tuberculosis granuloma (18%) were mainly responsible for narrow segments during bronchoscopy. A radiological tumor like mass was found histopathologically to be as lung cancer in 86% and as tuberculous granuloma in 5%. About 84% of lung cancer patients were either smokers (57%) or ex-smokers (27%) as compared to only 35% in smokers and 13% in ex-smokers in patients without lung cancer, P-value<0.01.

CONCLUSION: Flexible fiberoptic bronchoscopy can be performed safely whenever indicated. Complications occurred were minor and self limiting. Appropriate preparation, and close supervision and adherence to the protocol were essential for a successful and safe procedure.