Rigid Bronchoscopy

Abstract

Despite the expansion of flexible bronchoscopy, rigid bronchoscopy (RB) remains an important tool in respiratory medicine, especially for therapeutic purposes. In this study, we attempted to identify the main complications associated with RB and analyze possible risk factors. This retrospective study reviewed data from 775 RBs performed in a tertiary-care university hospital between 1992 and 1999. The majority of patients were men (n=557, 72%) with a median age of 47 years. Lung cancer was the diagnosis in 414 patients (53.4%), tracheobronchial stenosis was present in 84 (10.8%), and foreign bodies were seen in 155 cases (20%). Laser therapy was performed in 346 patients (44.7%), foreign bodies removed in 155 (20%), and only 197 RBs (25.4%) were performed for diagnostic purposes. Complications were seen in 103 patients (13.4%) and the majority of them were mild. Three deaths occurred (1 patient had respiratory failure and 2 had severe hemorrhage during the procedure). Sex, age, and the aim of the procedure were not associated with an increased incidence of complications. RB is an important procedure, especially for therapeutic bronchoscopic purposes, and is a safe technique if used properly. Preoperative risk assessment is essential in preventing complications. In our series, major complications were rare (mortality rate, 0.4%). Severe initial risk factors related to respiratory, cardiac, and/or hematologic disorders, carinal involvement, neoplastic disease, or the presence of foreign bodies were associated with increased complications.