[Bronchoscopy in Germany. Cross-sectional inquiry with 681 institutions]

Bronchoscopy represents an integral part of the diagnostic tools in pulmonary medicine. Recently, it has also gained considerable attention for its therapeutic properties. To elucidate equipment, indications and procedural techniques of bronchoscopy units, a retrospective survey of 1232 hospitals and practices is conducted. 687 questionnaires are received back (response rate 56%). 681 of which are statistically evaluated. Two thirds of the physicians in charge are internists, one third are pulmonary care specialists. A total of 200,596 endoscopic procedures is included. The majority of procedures is done with an average of 3 bronchoscopists and in over 57% (388) of cases with an average number of 100 or less procedures per year. The five main indications are tumor, hemoptysis, infection or pneumonia, drainage of secretions and suspected interstitial disease. Overall complication rate amounts to 2.7% with an incidence of 4.6% minor and 0.7% major complications and a bronchoscopy-related mortality of 0.02%. The patterns seen in premedication, intra- and post-procedural monitoring, disinfection practices as well as documentation are quite heterogeneous. It is suggested to establish revised and updated standards for bronchoscopy, which should take the data collected into particular account. Those standards should provide the basis for a high level bronchological care throughout Germany.