Safety of interventional bronchoscopy through complication review at a cancer center

Abstract

The complication rate with regard to bronchoscopy is comparable with historical controls according to the related literature, and their occurrence appears to be sporadic, not relevant to patient characteristics and mostly related to the bronchoscopy itself rather than the introduction of new techniques. Bronchoscopy remains safe along with technical innovations. However, risk recognition and effective prevention is essential.

Complications with Endobronchial Ultrasound with a Guide Sheath for the Diagnosis of Peripheral Pulmonary Lesions

“…Although the majority of hemorrhages spontaneously resolved or required local vasoconstrictor therapy only [15,24], severe hemorrhage after TBB has been reported to occur on rare occasions (0.73-2.8%) [18,19,21]. In the present study, there was no case of significant hemorrhage which required us to terminate the procedure prematurely.…”

“…Chest X-ray was performed only when the patient reported any symptoms suggestive of pneumothorax [15], because previous studies reported that routine chest X-ray to detect pneumothorax was not necessary for all patients after bronchoscopy [16,17]. A major complication was defined as an event which necessitated premature termination of the procedure or symptomatic postprocedural sequela, including pneumothorax, hemorrhage, infection, air embolism or another untoward life-threatening outcome [18]. Breakage of the guide sheath and/or the radial probe was also recorded.…”

Correlation of the Imaging Findings with Bronchoscopic Findings for the Detection of Endobronchial Lesions: A Systematic Review and Meta-Analysis

“…With these techniques, a clinician can interpret more accurately the information obtained by the axial CT [8]. Although chest CT can offer valuable information for suspected endobronchial lesions, fiberoptic bronchoscopy (FOB) usually represents the first choice diagnostic modality for the accurate diagnosis [10][11][12].…”

“…Moreover, an accurate histological diagnosis has to be obtained for the confirmation of the disease [9]. A useful method for this purpose is Fiberoptic Bronchoscopy (FOB), which usually represents the first choice diagnostic modality for the accurate diagnosis of a suspected lesion [10][11][12]. However, this method is subject to limitations too, as the sensitivity of bronchoscopic techniques decreases significantly for peripheral lesions and also it remains an invasive method with possible complications and restrictions for the elderly and more disabled patients [11,12].…”

Conventional transbronchial needle aspiration is promising for identifying EGFR mutations in lung adenocarcinoma

“…Taiwan's National Health Insurance (NHI) approved EGFR‐TKIs as first‐line treatment according to EGFR mutation status in June 2011. We have previously reported the learning curve and safety of conventional transbronchial needle aspiration (TBNA), its use after the introduction of positron emission tomography‐computed tomography (PET‐CT) staging, and the practice of using larger 19 G needles . Horiike et al revealed the suitability of samples obtained through TBNA, not limited to lymph nodes (LNs), to analyze EGFR mutation in non‐small cell lung cancer patients .…”