Rendimiento diagnóstico de la broncoscopia con biopsia transbronquial en el estudio de lesiones sugerentes de cáncer pulmonar / Bronchoscopy with transbronchial biopsy for the diagnosis of potentially malignant pulmonary lesions: experience in 261 patients

Background: Bronchoscopy is a minimally invasive procedure used for the diagnosis of lung cancer. Aim: To report our experience with bronchoscopy and transbronchial biopsies for the diagnosis of potentially malignant pulmonary lesions. Material and Methods: Revision of electronic records from patients who underwent transbronchial biopsies seeking for lung cancer. The diagnostic yield of the procedure was evaluated using pathology reports or a 24 months follow up. Results: 261 patients were included. Bronchoscopy was diagnostic in 65% of cases. Lesions mean diameter was 51 mm (range 9-120 mm). Diagnostic yield for lesions less than 30 mm was 59%, for lesions less than 35 mm was 61%, and for lesions over 40 mm was 69%. The presence of malignant lesions and their location in the superior or middle lobe were associated with a better predictive value of the procedure. TNM staging was IIIB/IV in 80% of the patient at the time of diagnosis. Conclusions: The diagnostic yield of bronchoscopy is influenced by the etiology and location of lung lesions.

Complicaciones asociadas a la broncoscopía flexible: análisis de registro post-procedimiento / Immediate complications following flexible bronchoscopy: Retrospective analysis of 1079 procedures

Background: Flexible bronchoscopy is a useful diagnostic tool with a relative low rate of complications. Aim: To analyze post procedure risk of complications after flexible bronchoscopy with transbronchial or bronchial biopsy. Material and Methods: The electronic database of a bronchoscopy unit at a general Hospital was analyzed. All procedures performed between 2009 and 2011 were reviewed and complications recorded. The primary outcome measure was the risk for complications de fined as the percentage of procedures complicated by hemorrhage, pneumothorax, desaturation < 80% and other complications. We used a logistic regression model to explore the association between each procedure characteristic and complication. Results: One thousand seventy nine procedures were included in the analysis. Eight percent had complications. Among these, the frequency of hemorrhage was 5.9% and pneumothorax was 0.3%. Factors associated with complications were exclusive use of topical anesthesia with an odds ratio (OR) of 1.72 (confidence intervals (CI): 1.04-2.86), regular or bad intolerance to the procedure with an OR 4.70 (CI: 3.00-7.38) and performing biopsies of the upper lobes with an OR of 1.76 (CI: 1.04-2.97). Conclusions: Exclusive use of topical anesthesia, performing biopsies of the upper lobes and procedure tolerance were risk factors associated with complications following bronchoscopic biopsies.