Bronchoscopy

"All interventions are performed under sedation in a room dedicated exclusively to this purpose. Most bronchoscopies are performed on an outpatient basis and do not require hospital admission".

DR. ANA BELÉN ALCAIDE OCAÑA
SPECIALIST. PNEUMOLOGY DEPARTMENT

The bronchoscopy is a diagnostic test that allows to visualize the airway (larynx, trachea and larger bronchi) and to collect samples of respiratory secretions, bronchial or lung tissue or nodes of the mediastinum. Sometimes it can have a therapeutic purpose.

Initially it was done by means of a rigid steel tube, which is currently used on some occasions, especially for therapeutic purposes. Rigid bronchoscopy requires general anesthesia.
 
Bronchoscopy with a flexible endoscope began in 1967 and is currently the most widely used. It is carried out by means of an elongated, flexible instrument of about 5-6 mm in diameter. It does not require general anesthesia, can be introduced through the nose or mouth and allows progress to smaller caliber bronchi.

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When is bronchoscopy indicated?

The bronchoscopy allows:

  • To inhibit a hemorrhage of the respiratory tract (hemoptysis) and to determine its origin.
  • Extract foreign bodies that have been aspirated into the airways.
  • Aspirate secretions that obstruct the airways.
  • Identify different germs in lung infections (tuberculosis or pneumonia).
  • To open the way in obstructions of the major bronchial tubes or trachea due to tumors, inflammatory tissue, etc. by means of different more complex techniques (laser, photodynamic therapy, brachytherapy, cauterization or cryotherapy).
  • Placing prostheses in the trachea or major bronchial tubes in narrowings of these pathways.

Most frequent indications of this test:

  • Lung cancer
  • Tracheal, bronchial or pulmonary foreign bodies
  • Lung infections
  • Lung nodule
  • Tuberculosis

Do you have any of these diseases?

You may need to have a bronchoscopy

How is bronchoscopy performed?

After administering medication to reduce the discomfort that this test may cause (anxiety, nausea or cough), an anesthetic solution is instilled in the nostrils and pharynx.

Initially, there is a sensation of bad taste, coughing and numbness in the throat, with a feeling of not being able to swallow or not breathing, and that is due to the anesthesia of the area.

Later the bronchoscope is introduced through the nostrils or mouth. The calm and deep breathing facilitates the good performance of the test and its good tolerance.

After advancing through the pharynx and larynx, the vocal cords are reached and passing through them to the trachea and bronchi. Local anesthesia is applied from the most external areas to the deepest ones.

Once the area to be treated has been located, it is possible to perform some complementary procedures that help the doctor to complete the diagnosis:

  • Bronchial biopsy: This involves collecting a sample of the bronchial wall with a tweezer for subsequent analysis.
  • Transbronchial biopsy: A sample of lung tissue is obtained through the bronchus. It is mainly performed for the study of some diseases called interstitial (pulmonary fibrosis) or pulmonary nodules. It is often performed with simultaneous radiology control.
  • Transbronchial or transtracheal puncture: Nodes or formations near the bronchus or trachea are punctured with a small needle.
  • Bronchial aspiration: Secretions from the bronchus are aspirated for examination of bronchial cells or search for germs, mainly tuberculosis.
  • Bronchoalveolar lavage: It consists of the instillation of serum inside a bronchus in a variable amount (80 to 150 cc.) and its later aspiration with the purpose of collecting samples from the alveoli. The analysis of the collected fluid is used for the diagnosis of tumors, interstitial diseases, infectious diseases, etc., as well as for research purposes.
  • Bronchial brushing: It is done through a small brush with which samples of the bronchial mucosa are collected. Its purpose is to analyze the cells of the mucosa to rule out tumors or their culture for the diagnosis of pneumonias of special severity or that do not respond to the prescribed treatment.
  • When local anesthesia has been used in the airway the normal cough and swallow reflex can take 1-2 hours to return and food and drink should not be taken until two hours later.
  • Some sedative substances are usually administered before the test, so it is recommended not to drive for several hours after the procedure.
  • Depending on the techniques that have been performed, the bronchoscopist will indicate the need to perform a chest X-ray or monitor possible bleeding after taking biopsies.
  • It is normal to expel a small amount of blood during the following 1 or 2 days. If any other problem appears or the bleeding is more important, you should contact the doctor who performed the test. Rarely, major complications occur.

Where do we do it?

IN NAVARRE AND MADRID

OUR MEDICAL TEAM

Specialists of the Pneumology Department

Specializing in smoking and tobacco-related diseases, the Department has over 15 years of experience in smoking cessation and lung cancer early detection programs.

The department's specialists have received training at leading centers around the world, including centers in the United States, and have extensive experience in the diagnosis and treatment of all respiratory diseases, both common and rare.

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Why at the Clínica?

  • Leading clinical assistance with great work in research and teaching.
  • Specialized nursing team.
  • We work together with the Sleep Unit and the Lung Cancer Area.

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