This information has been prepared to help you and your relatives understand more about your planned procedure. It also gives you general information about what to expect from the time of your admission to your discharge home from Unitas Hospital, and some practical advice on what to do when you get home.
Reasons For Needing A Bronchoscopy Or EBUS (Endobronchial Ultrasound)
A bronchoscopy is a procedure which can help to diagnose, and sometimes to treat conditions of the airways and lungs. Usually, it is performed as an outpatient or day case procedure.
There are a number of reasons why a patient may need a bronchoscopy. These may include coughing up blood, a persistent cough or an abnormal chest X-ray or CT scan. Bronchoscopy is performed routinely in patients after lung transplantation and is helpful in the diagnosis of difficult lung infections, inflammatory conditions, and tumors in the lung.
What Is A Bronchoscopy?
A bronchoscopy is a way of looking inside your lungs, while you are under anesthetic. It is a medical procedure in which a doctor passes a thin flexible telescope, called a bronchoscope, through your mouth and down your windpipe into the lungs.
The bronchoscope may be fitted with special equipment like a miniature ultrasound probe (EBUS) which can help to guide the doctor in taking samples at the right area.
What Samples Might Be Taken?
Samples are taken in a variety of ways depending upon the circumstances and can be used to test for infections in the lung, tumors and other sorts of lung disease.
During lung washings or lavage, saline (salt water) is squirted into the airways and then sucked out again, providing a sample of the cells from the lining of the lung.
Various instruments can be passed down the bronchoscope to collect a sample of tissue:
A thin brush on the end of a wire, used for brushing cells off the lining of the airways. A tiny pair of forceps is used to take little bites of lung tissue two to three millimeters in diameter. These are called biopsies. A fine needle is used to suck a sample of cells from lymph glands which lie next to the airways in the lungs. In each case, the sample obtained is put into preservative fluid and sent to the laboratory for testing.
What Are The Potential Risks Of Having A Bronchoscopy?
Overall a bronchoscopy is a safe procedure. However, as with any medical procedure, there may be risks involved, which will depend upon the type of procedure being undertaken.
Some patients notice a sore throat or some fever and sweating about six to twelve hours after bronchoscopy. These symptoms may last a few hours and will go away without any treatment. You may also feel a bit sleepy after the procedure.
Slight bleeding from the lung can occur when biopsies are taken. You may cough some bloodstained phlegm after the procedure.
More Serious Complications
Occasionally, more serious bleeding happens following a biopsy but this is unusual and occurs in less than one in 100 patients.
Occasionally a chest infection occurs following a bronchoscopy. If you start to cough up yellow/green phlegm or feel especially ‘chesty’ in the few days following a bronchoscopy this may be a sign of a chest infection. Your GP can advise you about the need for antibiotics.
Occasionally the lung may puncture and collapse when a biopsy is taken. This may result in some pain in the chest and some breathlessness. This rarely happens during bronchoscopy unless a special type of biopsy called a transbronchial biopsy is taken. If you need a transbronchial biopsy during your bronchoscopy, the doctor will talk to you about this beforehand and explain that the specific risk to you of experiencing a puncture during the process is about one in 20 (5%). If a puncture does occur then in five out of 10 cases it heals up by itself. Sometimes you may need to stay in the hospital and have a chest drain (a thin tube) inserted in between two ribs under local anesthetic to remove any air leaking from the lung.
Very Serious Complications
Death from bronchoscopy is exceedingly rare, about one in 5000. When it does occur the patient concerned has almost always been ill in hospital beforehand.
Your consultant will talk to you about the risks outlined above and how these relate to your own medical condition and health.
What Are The Benefits?
Your chest physician has recommended a bronchoscopy because it is felt that the benefit to you of having this test outweighs any risk. The benefit to you will be in obtaining a diagnosis of your chest problem so that the right treatment can be given. In cases where nothing abnormal is found, we can reassure you of this fact. The decision to offer you a bronchoscopy is taken carefully and with your best interests in mind.