Bronchoscopy is a procedure that lets doctors look at your lungs and air passages. It’s usually performed by a pulmonologist. During bronchoscopy, a thin tube (bronchoscope) is passed through your nose or mouth, down your throat and into your lungs, using sedation or general anesthesia. Bronchoscopy can also be used to obtain samples of mucus or tissue, to remove foreign bodies or other blockages from the airways or lungs, or to provide treatment for lung problems.
Why it’s done
- Abnormal Chest X-ray /CT Chest
- Chronic Cough
- Identification of a lung infection
- Diagnosis of a lung problem including lung cancer
- Removal of mucus, a foreign body, or other obstruction in the airways or lungs, such as a tumor
During some procedures, special tools are used to obtain a biopsy, an electrocautery probe to control bleeding or a laser to reduce the size of an airway tumor. Special techniques like Ultrasound and Fluoroscopy Navigation are used to guide the collection of biopsies to ensure the desired area of the lung is sampled.
In people with lung cancer, a bronchoscope with a built-in ultrasound probe may be used to check the lymph nodes in the chest. This is called endobronchial ultrasound (EBUS) and helps doctors determine the appropriate treatment. EBUS may be used for other types of cancer to determine if the cancer has spread.
Risks
Complications from bronchoscopy are uncommon and usually minor, although they are rarely severe. Complications may be more likely if airways are inflamed or damaged by disease. Complications may be related to the procedure itself or to the sedatives/ general anesthesia.
- Bleeding. Bleeding is more likely if a biopsy was taken. Usually, bleeding is minor and stops without treatment.
- Collapsed lung. In rare cases, an airway may be injured during bronchoscopy. If the lung is punctured, air can collect in the space around the lung, which can cause the lung to collapse. Patient is kept under observation if this problem is minor, but it may require admission to the hospital.
- Fever. Fever is relatively common after bronchoscopy but is not always a sign of infection. Treatment is generally not needed.
Patient Preparation
Food and medications
You may be asked to stop taking blood-thinning medications such as aspirin, clopidogrel (Plavix) and warfarin (Coumadin, Xarelto, Eliquis) several days before bronchoscopy. You’ll also be asked not to eat or drink for eight hours before the procedure.
Clothing and personal items
On the day of the procedure, you’ll be asked to put on a gown and take out any dentures, partial dentures or removable bridges. You may also be asked to remove hearing aids, contact lenses or glasses.
Other precautions
After the procedure, you’ll need a friend or family member to take you home. You won’t be able to drive because of the lingering effects of the medications used during the procedure. It’s also a good idea to have someone stay with you for the rest of the day.
What to expect
Bronchoscopy is usually done in a procedure room in a clinic or in a hospital operating room. The entire procedure, including prep and recovery time, typically takes about four hours. Bronchoscopy itself usually lasts about 60-90 minutes.
Before the procedure
You’ll be connected to monitors to track your heart rate, blood pressure and oxygen level during the procedure. You’ll be given general anesthesia, as a result you will not feel pain and have no memory of the bronchoscopy procedure once it is completed.
During the procedure
During bronchoscopy, the bronchoscope is placed in your mouth. The bronchoscope has a light and a very small camera at its tip that displays pictures on a monitor to help guide your doctor in performing the procedure. The bronchoscope is advanced slowly into the airways. Samples of tissue and fluid may be taken and procedures may be performed using devices passed through the bronchoscope. Pictures of the airways and abnormal findings will be taken.
After the procedure
You’ll be monitored for several hours after bronchoscopy. If no complications you will be discharged home to follow up in the office. You may have a mild sore throat, hoarseness, a cough or muscle aches. This is normal.
Call your doctor if you:
- Have increasing chest pain / shortness of breath
- Cough up more than a few tablespoons of blood
Results
Your doctor will usually discuss bronchoscopy results with you one to three days after the procedure. If a biopsy was taken during bronchoscopy, it will need to be reviewed by a pathologist. Because the tissue samples need special preparation, some results take longer than others to return. Your doctor will use the results to decide how to treat any lung problems that were found or discuss procedures that were done. It’s also possible that you may need other tests or procedures.