What is a bronchial endoscopy?
Bronchial endoscopy consists in introducing a long, flexible device, less than 1 cm in diameter, either through the nose or through the mouth, allowing visual examination of the trachea and bronchi.
What is the purpose of a bronchial endoscopy?
In addition to the merely visual examination of the trachea and bronchi, endoscopy provides the opportunity to carry out a series of additional examinations, such as cell sampling, biopsies (collection of small pieces of tissue), bacteriological or immunological examinations, as well as therapeutic interventions such as the identification of a bleeding site and a procedure to stop the bleeding.
The examination lasts between 15 and 30 minutes, depending on the individual situation.
How to prepare for it?
This examination requires that you have been fasting for at least 4 hours.
Local anesthesia (mouth, throat, vocal cords, and airways) is induced with an anesthetic spray and by injecting a liquid containing an anesthetic into the airways. To reduce the discomfort of the examination, a substance intended to dry the airways is also injected.
During the entire examination, and in order to prevent complications as much as possible, oxygen can be administered through the nose. The amount of oxygen in the blood is continuously monitored throughout the examination.
This examination can be carried out on an outpatient or inpatient basis.
What happens after the procedure?
Post-examination surveillance is mandatory before returning home.
Risks and discomforts
The injection of the substance to dry the airways may cause a transient blurring of vision for about 60 to 120 minutes. It is therefore forbidden to drive a car during the 6 hours following the examination as the effect of the sedative may be prolonged.
Nausea and cough (during local anesthesia). Sputum with blood in the hours following the procedure if biopsies are taken. High temperature, possibly up to 39°, in the 12 hours following the procedure (treatment with paracetamol). If the fever persists more than 24 hours after the examination, a medical consultation is necessary (possible infection). In case of hypersensitivity to the local anesthetic, severe complications may occur, including cardiac arrest (two cases of death out of more than 50,000 bronchial endoscopies have been reported in the literature). Severe blood pressure drops, cardiac arrhythmias, myocardial infarction, syncope, convulsions, breathing difficulties, and infections. In case of peripheral lung biopsies: pneumothorax which may require a hospital stay. Severe bleeding has been reported only exceptionally.
What happens in case of complications?
In case of complications, post-examination surveillance is prolonged and hospitalization may be necessary. Cardiac disorders may require medication, as may severe vagal reactions. In case of bleeding, a clotting agent can be applied to the bronchus.
There are some contraindications for this examination: new-onset coronary artery disease (angina), recent myocardial infarction, chronic bronchitis or severe emphysema, unstable bronchial asthma, or known coagulation disorders.
The use of aspirin is not a contraindication to performing bronchial endoscopy. However, it is advisable to stop taking it at least 7 days before the examination. Similarly, any anticoagulant treatment should be stopped before the examination. However, the opinion of the treating physician is desirable in this regard.
The return home
You are advised to stay at home and not to work on the day of the exam.
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