Abstract

Flexible Fibreoptic bronchoscopy (FFB) is a major diagnostic and therapeutic tool employed largely in respiratory medicine but its use in our country has been quite limited. We performed a retrospective review of the indications, overall diagnostic yield and safety of FFB at the Korle-Bu Teaching Hospital (KBTH). Retrospective study. Cardiothoracic Unit, Korle-Bu Teaching Hospital. All bronchoscopy records from January 2017 - December 2018. Eight-five bronchoscopy reports generated over a 2-year period were reviewed. Using a data extraction form, patient's demographic details, indications for FFB, sedation given, specimen obtained and results of investigation, and complications encountered were recorded and entered into SPSS version 22. Descriptive analysis was performed and presented as means and percentages. Suspected lung cancer was the predominant indication for bronchoscopy requests (55.3%). Diagnostic yield of endobronchial biopsy was 86.7% increased to 93.3% when biopsy was combined with bronchial washing cytology. Bronchial washing geneXpert was positive in 20.8% of sputum negative cases, and 20.7% of patients with unresolved pneumonia and bronchiectasis had a positive microbial yield. Overall mild complications occurred in 5.9% of patients with no mortality. Flexible bronchoscopy has a significantly high diagnostic yield, particularly in evaluating lung cancers and undiagnosed lung infections with minimal associated complications, hence increasing its availability in the country and widening the diagnostic scope at the cardiothoracic unit of the Korle-Bu Teaching Hospital. None declared.

Highlights

  • Flexible fibreoptic bronchoscopy (FFB) is an important medical procedure that involves the direct visualization of the tracheobronchial tree using a fibreoptic scope and is pivotal in diagnosing a variety of respiratory diseases, lung cancer.[1]

  • We retrospectively reviewed the records of 98 patients who had FFB between the periods of January 2017 to December 2019 at the endoscopy suite of the cardiothoracic unit of Korle-Bu Teaching Hospital (KBTH) using an Olympus EVIS EXERA II CLV160 bronchoscope

  • Being in a TB endemic country,[13] there is a high index of suspicion for pulmonary tuberculosis among patients with interstitial infiltrates on chest imaging, in the absence of a positive sputum GeneXpert, bronchoscopy with Broncho-alveolar lavage (BAL)/Bronchial washing (BW) is required to clinch diagnosis of Pulmonary Tuberculosis (PTB) or otherwise

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Summary

Introduction

Flexible fibreoptic bronchoscopy (FFB) is an important medical procedure that involves the direct visualization of the tracheobronchial tree using a fibreoptic scope and is pivotal in diagnosing a variety of respiratory diseases, lung cancer.[1] Flexible bronchoscopy has improved from the traditional rigid bronchoscopy, which has a limited scope of visualizing only the central airways unless combined with the versatile, flexible bronchoscope.[2] Rigid bronchoscopy is a more invasive procedure performed under general anaesthesia whiles FFB is mostly performed as a day case with conscious sedation. Evaluating interstitial lung diseases, inhalational injury, suspected bronchopleural or trachea-esophageal fistulae are other www.ghanamedj.org Volume 55 Number 1 March 2021

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