What is a bronchoscopy?
A bronchoscopy an endoscopic medical procedure that enables the doctor to examine, diagnose and treat the patient’s airways and lungs. The doctor inserts a small tube connected to a camera (called a bronchoscope) through the nose or mouth. The bronchoscope allows the doctor to get an internal view of the respiratory system, and to take photographs and videos as well. Samples of the tissue can be taken, too. Based on the results of the bronchoscopy, the doctor is able to plan the appropriate treatment for the patient’s condition.
When is a bronchoscopy required?
When the doctor notices any abnormality in the respiratory system or suspicious chest x-ray or CT scan, bronchoscopy is undergone to help examine or diagnose accurately. The most common conditions that require bronchoscopy:
- Chronic cough
- Hemoptysis (coughing up blood)
- Shortness of breath and low oxygen level
- A tumour or growth on a lung
- Any suspicious changes to the tissue, like scarring or collapse of an area of a lung
- An infection
- A fever
Doctors also use bronchoscopy to get a biopsy of tumours within the lungs that do not reach the bronchi using a technique known as endobronchial ultrasound (EBUS). In this procedure, a tumour deep in the airways is envisioned with ultrasound and biopsied during a bronchoscopy (an ultrasound-guided needle biopsy).
Autofluorescence bronchoscopy, narrowband imagery, and high magnification video bronchoscopy are other techniques designed to examine respiratory system deeper than the conventional bronchoscopy.
Bronchoscopy is also used to treat an airway problem. This involves:
- treating cancer
- removing a foreign object
- removing fluid or mucus
- Dilating blocked or narrowed airway
- Washing out an airway
In some certain treatments, bronchoscopy is performed with the assistance of brachytherapy, in which radiation is delivered directly to a tumour through the bronchoscope.
What is involved with having a bronchoscopy?
The patient should be fasting for 6–12 hours before bronchoscopy. Dentures need to be removed before the procedure. The patient should inform the doctor about medication he/she uses, especially diabetes and blood-thinning medication.
Before the procedure, the patient will receive medication to help him/her relax and minimise coughing. An intravenous line will be inserted for extra medications. The heart and the blood pressure will be monitored and extra oxygen will be given during the procedure.
Bronchoscopy is done under general or local anaesthetic in the case of flexible bronchoscopy, and general anaesthetic in the case of rigid bronchoscopy.
During the procedure, the doctor will slowly thread a bronchoscope through the patient’s nose or mouth, down the throat, past the vocal cords, through trachea and into bronchial tubes. The doctor will carefully examine the lining of the airways and may take a sample for laboratory examination. The doctor may also remove a foreign object. It might feel slightly uncomfortable to have the tube inserted. The tube may stay inserted in the patient’s airways for about 20 – 60 minutes, but the patient will be able to breathe.
Following the bronchoscopy, the patient will be spent to the recovery area to be monitored until the anaesthetic and sedation wears off. The doctor will send biopsy, mucus or liquid sample to a laboratory for examination. The patient will have an irritating feeling in his/her throat for not less than 24 hours (could be last for few days).
Is bronchoscopy totally safe?
Bronchoscopy is normally safe, but there is a tiny risk for fever, infection, minor bleeding, breathing difficulty or pneumonia. The possibility of pneumothorax, or collapsed lung, is a comparatively minimal, but still a serious side effect that can be treated immediately by the doctor.