Title: Role of Flexible Video Bronchoscopy in Diagnosis of Pulmonary Lesions
Authors: Dr Vishal R. More, Dr B.O. Tayade , Dr Sonal S. Arsude
DOI: https://dx.doi.org/10.18535/jmscr/v5i3.136
Abstract
Flexible video bronchoscopy is very useful & safe procedure for diagnosis of respiratory diseases. It can be performed under local anesthesia in various clinics/hospitals settings providing maximal visualization of tracheobronchial tree. The purpose of this article is to study the utility of Flexible video bronchoscopy in diagnosis of pulmonary lesions and various diagnostic techniques of bronchoscopy. we included cases where radiological & clinical examination or routine laboratory investigations could not clinch diagnosis & patients having persistant pulmonary lesions on chest xray in form of collapse, consolidation, nodule or mass. Case record form was maintained. All patients were subjected to sputum & hematological examination, chest xray, ECG, coagulation profile & CT scan thorax in some cases. Then patients were subjected to flexible video bronchoscopy. Appropriate samples such as bronchial wash, brushing, biopsy/trans-bronchial needle aspiration (if indicated) were obtained depending on the lesion after thorough evaluation of endobronchial tree. Mean age was 47.3±18.6 years. Nearly 2/3rd were males and rest were females. Over half of participants (55.4%) belonged to rural region. In bronchoscopy, Normal vocal cords were seen in(92.1%),left fixed cord (6.9%) & nodule on left vocal cord (2.0%). On evaluation after bronchoscopy Pulmonary TB was most common (24.8%) followed by bacterial pneumonia (24.8%) and malignancy (23.8%). Other diagnoses included fungal pneumonia and ILD. Bronchoscopy was nondiagnostic in 22.8% cases. Patients of respiratory complaints with lesion visible on chest xray who are undiagnosed can derive benefit by flexible bronchoscopy. Use of supportive techniques of bronchial wash, brushing, biopsy aid in diagnosis.
References
1. Ohata M. History and Progress of Bronchology in Japan.Bronchology - Japan Society for Bronchology. 1919;26:539–546.
2. Herth F. Bronchoscopic techniques in diagnosis and staging of lung cancer. Breathe. 2011;7(4):324–337.
3. Fuladi AB, Munje RP, Tayade BO. Value of washings and brushings, And Biopsy at fibreoptic bronchoscopy in the diagnosis of lung cancer. Journal, Indian Academy of Clinical Medicine.2004;5(2):137–142.
4. 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. 2010;27(3):118–121.
5. Gupta A.A, 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. 2015;32(3):211–215.
6. Garg B, Sood N, Sidhu UP, Malhotra V. Role of Fiberoptic Bronchoscopy and Utility of Bronchial Washings and Brushings in the Diagnosis of Lung Diseases.Indian J Chest Dis Allied Sci 2013;55:145-148.
7. Kapse VR, Mhaisekar DG, Totewad D, Kulkarni M. Study of comparison of yield of bronchial brushing and broncho-alveolar lveolar lavage in diagnosis of lung cancer.International Journal of Recent Trends in Science and Technology. 2016;19(1):69–72
8. Rawat J, Sindhwani G, Gaur D, Dua R, Saini S. Clinico-pathological profile of lung cancer in Uttarakhand. Lung India.2009; 26(3):74-6
9. Jain S RK, J AB, K PG. Role of fiberoptic bronchoscopy in patients with sputum smear negative for acid fast bacilli and chest x- ray suggestive of pulmonary tuberculosis. Journal of Evidence based Medicine and Healthcare.2015;2(2):155–164.
10. Bairagya TD, Biswas S, Das A, Das SK, Sinha A. The role of induced sputum in the diagnosis of pulmonary tuberculosis. Lung India.2013;30(3):199-202
11. Sherwani R, Akhtar K, Siddiqui T, Bhargava R, Zaheer S. Bilateral lower zone shadows on chest radiograph – A clinicopathological profile.Indian J Tuberc 2005; 52:137-142.
12. Høiby N, Koch C. Maintenance treatment of chronic Pseudomonas aeruginosa infection in cystic fibrosis.Thorax. 2000;55:349–350.
13. Singh R, Kaur H, Singh G. Dignostic yield of fiberoptic bronchoscopy in a teaching hospital. JK Sci. 2008;10(4):178–180
14. Mohamed SAA, Metwally MMA, Abd El-Aziz NMA, Gamal Y. Diagnostic utility and complications of flexible fiberoptic bronchoscopy in Assiut University Hospital: A 7-year experience. The Egyptian Society of Chest Diseases and Tuberculosis. 2013;62(3):535–540.
15. Joos L, Patuto N, Chhajed PN, Tamm M. Diagnostic yield of flexible bronchoscopy in current clinical practice. Swiss Med Wkly. 2006;136:155-159
16. Rao S, Rao S, Lal A, Barathi G, Dhanasekar T, Duvuru P. Bronchial wash cytology : A study on morphology and morphometry. J Cytol.2014;31(2):63–67.
17. Gracia JDE, Bravo C, Miravitlles M, Tallada N, Orriols R,Bellmunt J, et al. Diagnostic Value of Bronchoalveolar Lavage in Peripheral Lung Cancer. Am Rev Respir Dis.1993;147:649–652.
18. Clark RA, Gray PB, Townshend RH, Howard P. Transbronchial lung biopsy : a review of 85 cases. Thorax.1977;32:546–549.