Flexible Bronchoscopy Without Fluoroscopy in Peripheral Lung Tumors

Abstract

The use of bronchoalveolar lavage (BAL) to investigate peripheral bronchogenic carcinomas produces a variable yield and its significance when performed without the aid of fluoroscopy has not been established. To assess the relevance of BAL in the diagnosis of peripheral lung tumors, we prospectively analyzed the outcome of 22 flexible bronchoscopies (FFB) without fluoroscopy in peripheral lung cancer patients. The FFB provided a 45.5% yield. The ancilliary procedures carried out provided the following yields: bronchial lavage, 28.6%; BAL, 36.8%; bronchial brushing, 28.6%; brush lavage, 28.6%; and postbrushing bronchial lavage, 31.2%. The diagnostic yield from BAL was not statistically better than that of the other procedures. The highest yield with the lowest number of endoscopic methods was achieved with a combination of BAL and brushing lavage. Adding other procedures to this combination did not improve the diagnostic yield.