Elsevier

Respiratory Medicine

Volume 88, Issue 10, November 1994, Pages 749-753
Respiratory Medicine

Transbronchial lung biopsy through the fibre optic bronchoscope. Results and complications in 452 examinations

https://doi.org/10.1016/S0954-6111(05)80197-0Get rights and content

During 1986–1989, diagnostic fibre optic bronchoscopy (FOB) was performed in local anaesthesia in 1144 consecutive patients. Of these, 405 (35%) patients, median age 59 years, had transbronchial lung biopsy (TBB) performed under fluoroscopic guidance; 47 patients had a rebronchoscopy, i.e. in total 452 FOB were evaluated. The indication for TBB was localized pulmonary lesions in 279 (69%) patients, and diffuse pulmonary lesions in 126 (31%) patients. Localized lesions: TBB yielded a clinically relevant diagnosis in 55·2% of the patients. Of the 110 patients with malignancy, the overall diagnostic strength was 45·5%. Of the 159 patients with non-malignant lesions, 65·4% were diagnosed by TBB. The diagnostic yield increased with the number of biopsy specimens (≤4 biopsies, 52%; >4 biopsies, 70%, P<0·05). In 155 patients with well defined, circumscribed lesions, the diagnostic yield of TBB increased with the size of the lesion (<31 mm, 47%; 31–60 mm, 54%; >60 mm, 60%, P=0·09), and decreased with the distance of the lesion from the main carina (<61 mm, 70%; 61–100 mm, 52%; >100 mm, 40% P<0·02). Diffuse lesions: TBB yielded a clinically relevant diagnosis in 66·7% of the patients. Of the 15 patients with malignancy, 73·3% were diagnosed by TBB. Of the 93 patients with non-malignant lesions, 78·5% were diagnosed by TBB. The diagnostic yield showed a trend to increase with the number of biopsy specimens (≤4 biopsies, 65%; >4 biopsies, 71%, P=0·11). Complications: related to TBB were observed in 6% of the FOB; in 5·8% of the procedures a pneumothorax developed, and in 3·8% a chest tube was needed. Major bleeding was observed in 0·2% of the procedures. There was no relationship between the number of TBB and the complication rate, and there was no mortality.

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