Flexible Fiberoptic Bronchoscopy: Indications, Diagnostic Yield and Complications

Abstract

Background: Bronchoscopy is the use of flexible or rigid endoscopes to examine the airways. The flexible bronchoscope has the advantage of being able to view the third generation bronchioles. In recent decades, bronchoscopy has evolved from a diagnostic method to interventional and endobronchial ultrasound (EBUS) bronchoscopy. Objective: To know indications, diagnostic yield and complications of Flexible Fiberoptic Bronchoscopy. Methodology: We looked at the medical records of 153 individuals who had a bronchoscopic surgery at the Medical Teaching Institute, Lady Reading Hospital in Peshawar between September 2020 and September 2021, using patient files, bronchoscopy suit records and hospital HMIS. Before the procedure, each patient or patient's relative signed a written informed consent form. Demographic information, co-morbidities, indications for the procedure, radiological findings, bronchoscopy findings, final diagnosis, and bronchoscopy complications were all obtained. Results: Of 153 patients, 91 (59%) were men. Majority of the participants (52%) were above 60 years of age. Hypertension (40%) was predominant comorbidity, followed by DM-II (39%), Asthma (22%) and others. 40% patient had significant exposure to tobacco smoke. The primary indication for bronchoscopy was suspected pulmonary infections (27%), followed by suspected malignancy or a lung mass on CT (23%) and hemoptysis. Other indications include, bilateral hilar LN, Undiagnosed lung infiltrates in immunocomprised patients etc. Overall diagnostic yield was 51%. The most common finding on chest xray was air space shadowing, followed by lung mass, hilar lymphadenopathy and cavity formation. Other less common features on Xray and CT included interstial opacities and others. 13% of the xrays and 2.6% of the CTs were reported as normal. Conclusion: Despite significant expenditure in disease prevention, chest infections, particularly smear-negative MTB, are the most common reason for bronchoscopy procedures, followed by malignancy. In detecting this illness and other respiratory disorders, Flexible Bronchoscopy has a critical importance rule. Furthermore, it is a safe method with a high diagnostic yield for a variety of patients with respiratory illnesses. Keywords: Bronchoscopy; FFB; LRH; Peshawar