Study of Clinicoradiological Profile of Patients Undergoing Fiberoptic Bronchoscopy

Abstract

Introduction: Bronchoscopy is a procedure to visualize the tracheobronchial tree. There are three types of Bronchoscopy, rigid, flexible, and virtual Bronchoscopy. Rigid bronchoscopy visualizes the proximal airways. Flexible bronchoscopy is the most common type of bronchoscopy. It visualizes the trachea, proximal airways, and segmental airways up to the third generation of branching and can be used to sample and treat lesions in those airways. Flexible bronchoscopy is generally performed in a procedure room with conscious sedation. Aims and Objectives: To study the bronchoscopic findings in patients undergoing fiberoptic bronchoscopy. To study clinical and radiological profile of patients undergoing fiberoptic bronchoscopy. To correlate the bronchoscopic findings with clinical and radiological profile of patients undergoing fiberoptic bronchoscopy. Methodology: Present study was conducted in the department of Respiratory Medicine of a Medical College and tertiary health centre. A total of 72 patients were included in this study after satisfying inclusion and exclusion criteria. The cases were recruited from the department of Respiratory and the referred cases from other department were also included. Written informed consent was taken from all the patients after explaining complications occurring during and after bronchoscopy. Procedure was done under local anesthesia. Information regarding clinical features and radiological findings were noted in predesigned proforma. Results: In this study 72 patients underwent fiberoptic bronchoscopy. Procedure was done under local anesthesia in all these patients. All these were diagnostic bronchoscopies. The bronchoscopy was done more in male (68.05%) as compared to females (31.94%). Consolidation (43.06%) was most common radiological finding followed by meditational mass lesion (26.39%). The most common finding on bronchoscopy was growth (25%) followed by secretions (22.22%). However in 27.78% patients no bronchoscopic finding was seen; these were patients with subcarinal lymph node, some cases of pneumonias, some cases of bronchiectasis. In those cases where no finding was seen bronchoalveolar lavage was taken. BAL (68 cases) was the most common procedure done, second most common was lung biopsy of the visible growth (21) However biopsy of the visible growth was more accurate with the accuracy rate of 76.91% followed by trans bronchial lung biopsy of the suspected lesion. Bronchoscopy was conclusive to give final diagnosis in 56 out of 72 cases. There was positive correlation between clinicoradiological diagnosis and bronchoscopic diagnosis. In 59.72% cases there was positive correlation between bronchoscopy and clinicoradiological findings.consolidation (43.06%) was most common radiological finding followed by meditational mass lesion (26.39%). Conclusions: Bronchoscopy is an excellent tool for the diagnosis of lung diseases, Radiological and clinical evaluation is very important prior to the bronchoscopy. There is a correlation between clinicoradiological and bronchoscopic diagnosis.A multimodality approach for the diagnosis is always helpful.