Abstract
Flexible bronchoscopy is a common invasive procedure performed for diagnostic or therapeutic purposes. In this study we assess the diagnostic yield of routine bronchoscopic procedures.
Methods: Data from consecutive flexible bronchoscopic procedures performed at our University Hospital over a period of 6 months were analyzed retrospectively using procedure reports and computerized patient information system. The yield of diagnostic procedures analysed included mucosal bronchial biopsies, bronchial washings and bronchial brushings. To estimate diagnostic yield the final conclusion based on all available investigations was used.
Results: Of 149 procedures (male 55%, mean age 65 yrs) 78 were for suspected lung cancer, 34 for haemoptysis and 37 for other indications such as cavitating lung lesions, infection in an immune compromised patient and chronic cough. The overall diagnostic yield was 76.9%. Bronchoscopy performed for suspected lung cancer confirmed malignancy in 52.6%. This increased to 80% if an occlusive tumour was seen. In the 66 cases of confirmed lung cancer bronchial biopsy was performed in 38. Of this 6 were not diagnostic and in these 1 case was diagnosed by both wash and brush and 1 by only brush, the rest being non-diagnostic on bronchoscopy. In 25 cases where biopsies were not done brush or wash was diagnostic in 12. None of the procedures done for haemoptysis with normal radiological imaging demonstrated significant pathology. No significant complications were documented.
Conclusions: We confirm that bronchoscopic samplings are safe and have a high diagnostic yield. We also demonstrate the importance of bronchial washings and brushings to increase the diagnostic yield in lung cancer.
- © 2014 ERS