The diagnostic yield and complications of flexible bronchoscopies performed at a tertiary academic Hospital: a 5-year retrospective study (2015-2019)

Abstract

Background: There is very little or no data in South African relating to bronchoscopy practice, with a high incidence of lung cancer and lung disease. We, therefore, analysed the performance, indications, and outcomes of bronchoscopies at a tertiary hospital in South Africa. Objectives: To determine the diagnostic yield, indications and complications at a Tertiary Institution as well as determine the effectiveness of bronchoalveolar lavage (BAL) in making specific diagnoses such as cancer, sarcoidosis, asbestosis and infectious diseases like Mycobacterium tuberculosis (MTB) and Pneumocystis jirovecii pneumonia (PCP). Methods: 692 patients were identified and 647 cases analysed due to 45 cases with inadequate data for analyses. A single-centre retrospective cohort study of 647 patients analysed who underwent bronchoscopy between January 2015 and December 2019 was conducted at the Charlotte Maxeke Johannesburg Academic Hospital. Results: The epidemiology of the subjects showed a significant male predominance (63.65%), with a mean age of 55 years. The most common indication was suspected malignancy followed by non-resolving pneumonia, 41.19% and 40.87 % respectively. There were 116 of 401 (28.93%) malignancies confirmed on biopsy and 82 of 573 (14.41%) from bronchoalveolar lavage. Of all bronchoscopies performed, 85.92% had no complications during or after bronchoscopy but 10.8% were complicated with bleeding. Conclusions: This audit revealed that flexible bronchoscopy is safe and effective and associated with minimal risk. This study revealed the use of bronchoscopy in diagnosing lung malignancies/carcinomas and highlights the necessity of the availability of bronchoscopy.