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Year : 2013  |  Volume : 2  |  Issue : 4  |  Page : 249-254

Utility of flexible fiber optic bronchoscopy: Experience from a tertiary care teaching hospital

Department of Pulmonary Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India

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Rahul Magazine
Department of Pulmonary Medicine, Kasturba Medical College, Manipal University, Manipal - 576 104, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2277-8632.122159

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Aims: To identify the indications for flexible fiber optic bronchoscopy (FOB) and to compare the pre- and post-bronchoscopy diagnoses. Settings and Design: A retrospective case record based study of 322 subjects who had been admitted in the different wards of a tertiary care teaching hospital in south India and had undergone flexible fiber bronchoscopy for various indications was conducted. Materials and Methods: The demographic data, chest radiographic findings, pre-bronchoscopy suspected clinical diagnosis, bronchoscopy findings, microbiological results, pathological data, and post-bronchoscopy confirmed clinical diagnosis were recorded as per a pre-designed pro forma and analyzed. Results: The mean age of the patients was 52.99 years (SD ± 15.1, range: 17-82). The top three pre-bronchoscopy suspected clinical diagnoses were pulmonary tuberculosis (n = 129, 40%), lung malignancy (n = 99, 30.7%), and bacterial pneumonia (n = 57, 17.7%). The distribution of the clinical diagnoses post-bronchoscopy was as follows: Bacterial pneumonia (n = 58, 18%), lung malignancy (n = 56, 17.4%), and pulmonary tuberculosis (n = 28, 8.7%). FOB confirmed the diagnoses of lung malignancy, bacterial pneumonia, and pulmonary tuberculosis in 45.5%, 31.6%, and 18.6% of the respective suspected diagnostic categories. Twenty-four (85.7%) cases of confirmed pulmonary tuberculosis and 45 (80.4%) cases of confirmed lung malignancy were rightly suspected by the clinician prior to bronchoscopy. Overall, the diagnosis could be established in 142 (44.1%) cases with the help of FOB. Conclusion: Bronchoscopy could establish a diagnosis in less than half of the cases. The commonest suspected pre-bronchoscopy clinical diagnosis was pulmonary tuberculosis, but the commonest confirmed post-bronchoscopy diagnosis was bacterial pneumonia. Lung malignancy category had the best correlation between pre-bronchoscopy and post-bronchoscopy diagnosis.

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