Chest
Original ResearchIs Routine Chest Radiography After Transbronchial Biopsy Necessary?: A Prospective Study of 350 Cases
Section snippets
Materials and Methods
All consecutive patients referred for FB with fluoroscopically guided TBB at the Rabin Medical Center, Beilinson Campus, Petah Tiqwa, Israel, between December 2001 and January 2004 were enrolled in the study. FB was performed with midazolam, 1–2 mg IV as needed, and fentanyl, 0.5 mg, sedation. Each patient underwent CXR within 2 h after the procedure, in accordance with our departmental policy. The CXR films were examined by radiologists blinded to the study protocol and the patient’s clinical
Results
Of 1,227 consecutive bronchoscopies performed in our institute between December 2001 and January 2004, 350 procedures (29.5%) included TBB. Indications for FB with TBB were suspected cancer (n = 96, 27.4%); lung or heart-lung transplantation (n = 91, 26%); persistent infiltrates (n = 63, 18%); interstitial lung disease (n = 42, 12%); suspected sarcoidosis (n = 33, 9.4%); suspected tuberculosis (n = 14, 4%); and others (n = 11, 3.2%). One hundred twenty-two patients (34.8%) were considered
Discussion
The present study is the largest prospective investigation examining the role of routine CXR following FB with TBB. In this study, the large majority of patients (97%) had no radiographic pneumothorax and no clinical symptoms. The four patients found by CXR to have large pneumothoraces requiring treatment were all symptomatic, and physicians suspected pneumothorax before CXR in all of them. Only three patients who were asymptomatic had pneumothorax, but the pneumothoraces were small (≤ 10%) and
ACKNOWLEDGMENT
The authors thanks Dr. T. K. Aldrich, Chief, Unified Pulmonary Division of the Albert Einstein College of Medicine, Bronx, NY, for critical review of this article.
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