Bronchoscopy

What is bronchoscopy?

Flexible bronchoscopy is usually performed by a lung specialist. This is a method to look inside the airway passage to the lung and do various procedures. The instrument looks like a long black straw but has a light and camera at the tip.

 

Why do we do bronchoscopy?

We do this procedure to look for changes in the airway or to take a piece of lung (biopsy). We often wash an area of the lung with salty water to look for infection or cells that will aid in the diagnosis of a lung illness. This can also be used to remove foreign bodies such as a piece of food.

 

What do you need to do prior to the procedure?

The first step is to understand the reason the procedure is being done. Once you’ve understood the risks and agreed to the procedure, there is a consent form that needs to be completed, which is found under Patient Forms on this website.

Certain medications such as Clopidogrel, Warfarin, Xarelto and Eliquis need to be stopped prior to the procedure. It is therefore crucial to give a list of your current medication to the lung specialist.

Also, you have to fast from the previous evening (ie nothing to eat OR drink), otherwise the anaesthetic risk is increased and the procedure likely to be cancelled.

 

What are the risks involved with the procedure?

This is a very safe procedure with complications occurring only rarely (less than 1 % of the time). The most common complications include soreness in the nose from the instrument (usually goes away with Panadol), or a drop in blood pressure due to sedation (the medication used to put you asleep before the procedure). This can be easily managed by the attending anaesthetist. 

Other problems we sometimes encounter are spasm of the airway or vocal cords, drop in oxygen level, bleeding from the nose, heart rhythm changes, infection or very rarely, seizure. All these complications are usually easily managed by the team caring for you.

Major complications are particularly uncommon with the overall risk of pneumothorax (collapsed lung after a lung biopsy) is about 1 in 600, significant bleeding 1 in 800 and breathing failure 1 in 500. Death from the procedure is extremely rare (approximately 1 in 8,000 in one study) and is associated with severe heart disease or severe airway obstruction).

 

What are the risks after the procedure?

Complications after the procedure include fever, cough, and low oxygen. Fever is most likely if washing of a lung segment was performed. The fever is generally treated with paracetamol and with antibiotics if the fever continues for more than 24 hours. Low oxygen may require supplemental oxygen until you recover.

Complications of the local anaesthetic used (lignocaine) are uncommon, but may include tachycardia, methemoglobinemia, hypoxemia, cyanosis, confusion, anxiety, lethargy, and dizziness.

 

When can you go home?

It takes a few hours to recover from the sedation given during the procedure. You cannot drive home yourself and will require someone to take you home.

 

How long does it take to get results?

It usually takes about a week to get the majority of results, although there are a few exceptions (eg if TB is suspected) that can take up to 6 weeks or more.