Bronchoscopy, indications, safety and complications

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.

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.

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.

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.