Bronchoscopy
Bronchoscopy is a medical procedure that allows doctors to visually examine the respiratory tract and lungs using a bronchoscope—a thin tube equipped with fiber optics or a miniature camera. This diagnostic technique is primarily employed to investigate suspicious tissues, perform biopsies, and detect cancer cells in the respiratory system, including lung cancer. The procedure typically involves local or general anesthesia and is often performed on an outpatient basis, necessitating post-procedure transportation arrangements for the patient.
During bronchoscopy, the physician inspects the airways and lungs, and may conduct a bronchoalveolar lavage to collect samples for further analysis. While generally considered safe, the procedure carries some risks, including infection, bleeding, and rare complications such as lung perforation. Post-procedure, patients may experience temporary hoarseness or cough, and are advised to avoid eating or drinking until anesthesia effects subside. With advancements in technology, less invasive methods for lung cancer detection, such as robotic-assisted bronchoscopy and ultrasound-guided biopsies, are being developed, enhancing the efficacy and safety of this vital diagnostic tool.
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Subject Terms
Bronchoscopy
ALSO KNOWN AS: Fiber-optic bronchoscopy
DEFINITION: Bronchoscopy uses a bronchoscope to allow a doctor to see, examine, and biopsy tissues in the respiratory tract and lungs. The procedure is used to check for cancer cells. A bronchoscope is a thin tube equipped with fiber optics or a miniature camera that produces images of the internal airways and lungs.
Cancers diagnosed: Respiratory tract cancer, lung cancer
Why performed: Bronchoscopy is a diagnostic procedure used to view the inside of the airways and lungs. Suspicious tissues are biopsied and examined in a laboratory to detect the presence of cancer cells.
Patient preparation: Patients should stop taking aspirin or blood-thinning medication a week before the procedure. Bronchoscopy uses local or general anesthesia. Patients receiving general anesthesia should not eat or drink after midnight before the day of the procedure. Bronchoscopy is usually an outpatient procedure, and patients should arrange to have someone else drive them home. Patients wear an examination gown removed from the waist up during the procedure and receive a sedative before the bronchoscopy begins.
Steps of the procedure: Patients receive general or local anesthesia, depending on whether a rigid or flexible bronchoscope is used. Local anesthesia is injected or sprayed into the throat. Patients receive medication to eliminate secretions and to prevent coughing or gagging. Monitors are placed to measure blood pressure, blood oxygen levels, and heart activity. Oxygen is delivered through a nasal cannula. The bronchoscope is inserted through the nose or mouth. The airways and lungs are inspected. A bronchoalveolar lavage may be performed, which involves inserting sterile fluid to remove mucus or cells for examination. A tissue biopsy is taken by clipping a sample of abnormal tissue. At the end of the procedure, the fluid and bronchoscope are removed.
After the procedure: Patients may receive a chest x-ray following the procedure to ensure that the lungs were not punctured. Patients should not eat or drink until the anesthesia wears off in order to prevent choking. Patients may be hoarse, experience fever, or cough up small amounts of blood.
Risks: Bronchoscopy is considered a safe procedure. The primary risks are infection and bleeding. There is a slight risk of lung perforation, heart attack, irregular heartbeat, and low blood oxygen.
Results: A healthy respiratory tract and lungs are free of swelling and abnormal growths. Suspicious growths are biopsied to determine whether cancer is present.
In the mid-2020s, advances in bronchoscopy are progressing rapidly. A focus has been on the development of less invasive diagnostic approaches to detect lung cancer. For example, new procedures can use ultrasound in combination with ultra-thin biopsy tools. Robotic-assisted bronchoscopy and augmented fluoroscopy tools have been developing to help assist surgical navigation to cancerous areas of the lung.
Bibliography
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