Flexible fiberoptic bronchoscopy in respiratory care: Diagnostic yield, complications, and challenges in a Nigerian Tertiary Center

Abstract

Introduction: Flexible fiberoptic bronchoscopy (FOB) is a key diagnostic and therapeutic procedure in pulmonology. Experience with fiberoptic bronchoscopy is scanty in most developing countries.

Objectives: The goal of this study was to report our experience and clinical utility of fiberoptic bronchoscopy.

Methods: A review of bronchoscopy requests, services, and reports performed over a 5‑year period was performed. Demographic characteristics were extracted. Indications for the procedures, type of bronchoscopic sampling done, final diagnosis, and complications were reported. Sensitivities, specificities, and overall diagnostic yield of the procedures were determined.

Results: About 163 diagnostic bronchoscopies were performed during the study. Ninety‑nine patients with complete data were analyzed. Mean age was 54.8 ± 19.2 years, with males constituting the majority, 56.6%. Suspected bronchial cancer and pleural effusion were the main indications for bronchoscopy (33% and 19.1%, respectively). A total of 80, 39, and 99 bronchial washings, brushings, and bronchial biopsies were performed, respectively. Bronchial cancer was confirmed in 51.5% and was diagnostic in 57% of suspected pleural effusion. Pulmonary tuberculosis was confirmed in 50% of suspected cases and additional 8 cases were diagnosed. The overall diagnostic yield of bronchoscopy was 62%. Specificities of bronchial brushing and washing cytology for excluding bronchial cancer were 90.9 and 83%, respectively, and sensitivities of detecting bronchial cancer were 64.3% and 59%, respectively, P < 0.05 each. Serious complication occurred in about 1%. There was no mortality.

Conclusions: These results show that FOB is a useful and safe procedure with a low complication rate in our setting.

Keywords: Bronchoscopy, challenges, complications, Nigeria yield