Diagnostic bronchoscopy: an experience in a hospital of limited resources
DOI:
https://doi.org/10.18203/2320-6012.ijrms20184188Keywords:
Bronchoscopy, Bronchoalveolar lavage, Diagnostic bronchoscopyAbstract
Background: Diagnostic bronchoscopy is conventionally performed in evaluating undiagnosed abnormal chest x-ray findings, undiagnosed haemoptysis, pleural effusion, unexplained cough and collapse of lung etc. One indispensable use currently is for diagnosis of lung cancer. The aim of the study was to study the various types of patients who have undergone Diagnostic Bronchoscopy in a hospital of limited resources and the diagnostic outcomes of the procedures.
Methods: A retrospective study of Bronchoscopies was done from October 2016 to January 2018, in Department of Respiratory Medicine in the hospital of a Medical College. All 178 patients of all age and any sex were included in the study. These patients present in the study had chest X-ray and CT scan of thorax. Other investigations done were ZN stains for AFB and CBNAAT-TB (Cartridge Based Nucleic Acid Amplification Test) for sputum and blood complete haemogram, prior to bronchoscopy.
Results: Our study has shown that Diagnostic bronchoscopy is particularly useful in diagnosis of lung cancer, sputum smear negative Tuberculosis, if proper selection of cases is done even in a centre of limited resources. It has become an absolute necessity in a medical college hospital.
Conclusions: Bronchoscopy in our resource limited set up shows that it is an indispensable tool for diagnosis of lung cancer with patients with clinical presentations of lung collapse, unresolved consolidation, lung masses, undiagnosed pleural effusions and haemoptysis. The usefulness can be much better if facilities like TBNA, EBUS are made available.
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References
Noriaki Kurimoto and Teruomi Miyazawa. Flexible Bronchoscopy. 3rd Edition. Wiley Blackwell. Chapter 1, Bronchoscopy in the New Millennium. 2012:3.
Ong PG, Debiane LG, Casal RF. Recent advances in diagnostic bronchoscopy. J Thoracic Dis. 2016 Dec; 8(12):3808.
Decalmer S, Woodcock A, Greaves M, Howe M, Smith J. Airway abnormalities at flexible bronchoscopy in patients with chronic cough. Eur Resp J. 2007 Dec 1 ;30(6):1138-42.
Mehra PK, Woessner KM. Dyspnea, wheezing, and airways obstruction: is it asthma? Allergy Asthma Proc. 2005 Jul-Aug;26(4):319-22.
Smiddy JF, Elliot RC. The evaluation of hemoptysis with fiberoptic bronchoscopy. Chest. 1973 Aug; 64(2):158-62.
Feinsilver SH, Fein AM, Niederman MS, Schultz DE, Faegenburg DH. Utility of fiberoptic bronchoscopy in nonresolving pneumonia. Chest. 1990 Dec; 98(6):1322-6.
Sosenko A, Glassroth J. Fiberoptic bronchoscopy in the evaluation of lung abscesses. Chest. 1985;87(4):489-94.
Su WJ, Lee PY, Perng RP. Chest roentgenographic guidelines in the selection of patients for fiberoptic bronchoscopy. Chest. 1993 Apr; 103(4):1198-201.
Gunnels JJ. Perplexing pleural effusion. Chest. 1978 Oct; 74(4):390-3.
Chang SC, Perng RP. The role of fiberoptic bronchoscopy in evaluating the causes of pleural effusions. Arch Intern Med. 1989;149(4): 855-7.
Baaklini WA, Reinoso MA, Gorin AB, Sharafkaneh A, Manian P. Diagnostic yield of fiberoptic bronchoscopy in evaluating solitary pulmonary nodules. Chest. 2000 Apr; 114(4):1049-54.
Prakash UBS, Stubbs SE. Bronchoscopy in North America: the ACCP survey. Chest. 1991 Dec;100(6):1668-75.
Khalil KF, Butt T. Diagnostic yield of bronchoalveolar lavage gene Xpert in smear-negative and sputum-scarce pulmonary tuberculosis. J Coll Physicians Surg Pak. 2015 Feb 1;25(2):115-8.
Gay PC, Bruntinel WM. Transbronchial needle aspiration in the practice of bronchoscopy. Mayo Clin Proc. 1989 Feb; 64(2):158-62.
Harrow E, Halber M, Hardy S, Halteman W. Bronchoscopic and roentgenographic correlates of a positive transbronchial needle aspiration in the staging of lung cancer. Chest. 1991 Dec 1;100(6):1592-6.
Dasgupta A, Jain P, Minai OA, Sandur S, Meli Y, Arroliga AC, et al. Utility of transbronchial needle aspiration in the diagnosis of endobronchial lesions. Chest. 1999 May 1;115(5):1237-41.
Wahidi MM, Jain P, Jantz M, Lee P, Mackensen GB, Barbour SY, et al. American college of chest physicians consensus statement on the use of topical anesthesia, analgesia, and sedation during flexible bronchoscopy in adult patients. Chest. 2011;140(5):1342-50.
Vaidya PJ, Leuppi JD, Chhajed PN. The evolution of flexible bronchoscopy: From historical luxury to utter necessity. Lung India: official organ of Indian Chest Society. 2015 May;32(3):208.
Fein AM, Feinsilver SH. The approach to non-resolving pneumonia in the elderly. Semin Respir Infect. 1993 March; 8(1):59-72.
Vaidya PJ, Kate AH, Chhajed PN. Endobronchial ultrasound‑guided transbronchial needle aspiration: The standard of care for evaluation of mediastinal and hilar lymphadenopathy. J Cancer Res Ther. 2013;9:549‑51.
Gupta AA, Sehgal IS, Dhooria S, Singh N, Aggarwal AN, Gupta D, et al. Indications for performing flexible bronchoscopy: Trends over 34 years at a tertiary care hospital. Lung India: official organ of Indian Chest Society. 2015 May;32(3):211.
Kumar R, Singh M, Gupta N, Goel N. Bronchoscopy in immediate diagnosis of smear negative tuberculosis. Pneumonol Alergol Pol. 2014;82(5):410-4.
Tueller C, Chhajed PN, Buitrago‑Tellez C, Frei R, Frey M, Tamm M. Value of smear and PCR in bronchoalveolar lavage fluid in culture positive pulmonary tuberculosis. Eur Respir J. 2005 Nov; 26(5):767‑72.
Bachh AA, Gupta R, Haq I, Varudkar HG. Diagnosing sputum/smear-negative pulmonary tuberculosis: does fibre-optic bronchoscopy play a significant role?. Lung India: official organ of Indian Chest Society. 2010 Apr;27(2):58.
Chawla R, Pant K, Jaggi OP, Chandrashekhar S, Thukral SS. Fibreoptic bronchoscopy in smear-negative pulmonary tuberculosis. Eur Resp J. 1988 Oct 1;1(9):804-6.
Tamura A, Hebisawa K, Tanaka G, Tatsuta H, Tsuboi T, Nagai H, et al. Active pulmonary tuberculosis in patients with lung cancer. Kekkaku. 1999 Nov; 74(11):797-802.
Bhadke B, Munje R, Mahadani J, Surjushe A, Jalgaonkar P. Utility of fiberoptic bronchoscopy in diagnosis of various lung conditions: Our experience at rural medical college. Lung India: official organ of Indian Chest Society. 2010 Jul;27(3):118.
Johnson JL. Slowly resolving and nonresolving pneumonia: questions to ask when response is delayed. Postgraduate Med. 2000 Nov 1;108(6):115-22.