The safety of outpatient transbronchial biopsy

Fiberoptic bronchoscopy (FOB) is an accepted outpatient procedure, but transbronchial biopsy (TBB) is generally reserved for hospitalized patients. Over a three-year period, we performed fluoroscopically guided TBB in 148 of 688 outpatients undergoing FOB. Following the procedure, fluoroscopy was used to screen for possible pneumothorax in those patients who had had TBB. All patients were observed for one hour and then discharged if stable. Three patients (2.02 percent) were admitted and observed for acute hemoptysis following TBB. Bleeding ceased spontaneously in each. The remaining 145 patients were discharged after one hour of observation. One patient (0.68 percent) required Heimlich tube treatment for a delayed pneumothorax. Our experience indicates a low incidence of delayed complications in patients who are asymptomatic for one hour following TBB. We conclude that patients do not require hospitalization solely for TBB.