WHAT IS BRONCHOSCOPY?

Bronchoscopy is an advanced technique for the diagnosis of lung diseases. In it, a special endoscope, called a bronchoscope, is inserted into the lungs and airways. With the help of this procedure, different samples can be taken from the lungs and diagnosis of diseases made.

WHEN IS IT NEEDED?

Bronchoscopy is done mostly for diagnosis of lung diseases. Some of the diseases which can be diagnosed are:

  • Lung infections like tuberculosis, pneumonia, fungal infections
  • Interstitial lung disease (ILD) – In ILD the lungs starts shrinking leading to dry cough and difficulty in breathing. This can happen because of infections, immunity problems, dust exposure, organic dusts, etc. A lung biopsy (piece of the lung) needs to be taken for microscopic study in this case. The most common ILD is sarcoidosis which needs bronchoscopy for diagnosis.
  • Lung cancer – Lung cancer is very common in our country, especially in smokers. Most of the time the onset is very gradual and the patient will not have any symptoms at all until a late stage. A biopsy of the cancer needs to be taken for correct diagnosis which is most of the time done by bronchoscopy.
  • Other indications include removal of foreign bodies, removal of secretions in ICU patients, evaluation of blood in sputum, etc.
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HOW IS BRONCHOSCOPY DONE?

Bronchoscopy is mostly an out patient procedure done under local anesthesia. It generally is done within 15 -2 0 minutes and is not associated with any significant pain or discomfort. Mostly, it is the patients’ fear or panic which causes problems rather than any procedure related issues.

WHAT TO EXPECT HERE?

  1. Patient will be evaluated in the OPD and explained the need for bronchoscopy.
  2. Some pre bronchoscopy tests are advised and patient is given a date.
  3. Patient has to come fasting – approximately 5 hours – on the day of the procedure. No liquids – including water – or solid food is to be taken during this period.
  4. Before the procedure, local anesthetic in nebulised form is given.
  5. Patient is then taken up in the bronchoscopy room; monitoring equipment is attached.
  6. Some local anesthethic gel is then inserted into the nose.
  7. The bronchoscope is then inserted through the nose into the lungs and the procedure done.
  8. There might be some cough during the procedure.
  9. The bronchoscopy generally finishes within 15 – 20 minutes.
  10. After the procedure the patient is kept under observation for some time and then discharged.
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WHAT PROCEDURES ARE DONE?

Important procedures commonly done with bronchoscopy include taking pieces of any growth or tumour in the airway for diagnostic purposes (endobronchial biopsy – EBB), taking pieces of lung tissue (trans-bronchial lung biopsy – TBLB) and taking samples from abnormally enlarged lymph nodes (trans-bronchial needle aspiration –TBNA). Bronchoscopy is especially required for the management of diseases such as lung cancer, sarcoidosis, interstitial lung diseases, etc.

IS BRONCHOSCOPY SAFE?

Bronchoscopy is an extremely safe procedure. However, some minor complications may occur. These are mostly of little significance.

Most commonly, there may be some soreness in the throat due to the passage of the bronchoscope. It will resolve within 2 days. Occasionally, blood stained sputum may be noticed after the procedure which will also disappear within 2-3 days.

In less than 1% of cases, lung biopsy may lead to puncture of the lung  – a condition called as pneumothorax. The patient needs to be admitted and given oxygen for a day or two after which the condition mostly resolves.

SUMMARY

Bronchoscopy is valuable tool to diagnose lung diseases. It is safe and effective when done properly and in the right hands.

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