To assess safety and rate of complications of trans bronchial biopsies:A single centre experience.

Title: To assess safety and rate of complications of trans bronchial biopsies:A single centre experience.
Author(s): W.Mahmood U.Khan O.Rahman K.Rana A.O'Brien
Institution: University Hospital Limerick.
Poster: Click to view poster
Category: General Respiratory and Sleep
Abstract: Introduction: Bronchoscopy with/without fluoroscopy is employed in the diagnosis of a variety of lung diseases such as peripheral lung masses, focal/diffuse lung infiltrates, suspected fungal/mycobacterial lung infections. Complications include penumothoraces, bleeding and infections. Whether use of fluoroscopy decreases this rate is unclear. At UHL, all transbronchial biopsies are performed without fluoroscopy due to lack of access.

Objectives: To assess safety and rate of complications of transbronchial biopsies without fluoroscopy.

Methods: In this retrospective study, 95 patients underwent flexible fiberoptic bronchoscopy with transbronchial biopsy (without fluoroscopy) with different pulmonary pathologies at UHL in last 6 months.44 were male and 51 were female. Average age was 70 years (+/-11). Of these, 51 also had transbronchial needle aspirations (53%), 57 bronchoalveolar lavage (60%), 13 brush biopsies (13.6%).

Results: 8 (8.4%) patients suffered complications secondary to transbronchial biopsies: 6 (6.3%) were pneumothoraces, and 2 (2.1%) were significant bleeding. One patient required chest drain insertion while the remainder of the patients with pneumothoraces were managed conservatively. Patients with bleeding were managed with cold saline +/- adrenaline. Patients who suffered from pneumothoraces required hospital admission and the mean duration of inpatient stay was 2 days (+/-1). There were no deaths.

Our results were consistent with a recent meta-analysis showing rate of pneumothorax ranges between 0.4 - 5.8% in studies with use of fluoroscopy, and 1.5 - 20.2% without the use of fluoroscopy.

Conclusion: Our study shows that transbronchial biopsies without fluorosopy are a relatively safe procedure, and that fluoroscopy may not reduce the complication risk. Experience and training play a much more fundamental role in reducing complication rates.