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Dr. Manoj K Goel
Director & Head
Dept of Pulmonology, Critical Care & Sleep Medicine
Fortis Memorial Research Institute,Gurugram(Delhi & NCR)

BRONCHOSCOPY WITH LUNG  BIOPSY(TBLB/CRYOBIOPSY/ENDOBRONCHIAL BIOPSY)

Details of procedure : 


Bronchoscopy involves placing a thin tube-like instrument called a bronchoscope  through the nose or mouth and downinto the airways of the lungs. The tube has a mini-camera at its tip,and is able to carry pictures back to a video screen or camera. Using a bronchoscope the doctor is able to see the interior of the airway and any abnormality associated with it and decide upon the type of sample to be taken. Depending on findings a biopsy forcep or a cryo probe is introduced via the working channel of the bronchoscope and  a TBLB/ cryobiopsy or endobronchial biopsy is taken. In selected cases the biopsy may be done under guidance of radial probe EBUS.

Possible risks and complications

Every effort will be made to conduct the procedure in such a way as to minimize discomfort and risks.  However, I understand that just as with other types of prodedures, there are inherent potential risks of this procedure. 

The incidence of major complications associated with bronchoscopy are 0.8% - 1.3%. 

The complications include accumulation of air in pleural space, hemorrhage, subcutaneous emphysema, postoperative fever, chest infection, cardiac arrhythmias, hypoxemia, vasovagal attack, myocardial infarction, pulmonacy oedema, bronchospasm, choking, perforation of airway. The risk of pneumothorax with cryo-biospy is 5%.  The mortality rate associated with bronchoscopy is <0.01

 

Post procedure course: 

 

1) Postoperative oxygen supplementation may be required in some patients, particularly those with impaired lung function and those who have been sedated.

2) A chest radiograph is carried out post procedure

3) Patients who have had transbronchial biopsies  should observe for  pain chest, breathlessness, haemoptysis, surgical emphysema , excessive cough which can indicate pneumothorax after leaving hospital and they should contact hospital emergency.

4)Patients who have been sedated  are advised to   not  drive, sign legally binding documents, or operate machinery for 24 hours after the procedure.

5) It is preferable that day case patients who have been sedated should be accompanied home and that higher risk patients such as the elderly or those from whom transbronchial biopsy specimens have been taken should have someone to stay with them at home overnight

 

 

 

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