Bronchoscopy: Treatment, Effect & Risks

A bronchoscopy is an examination and treatment procedure used in human medicine. It involves inserting an endoscope into the bronchial tubes, which allows the attending physicians to make accurate diagnoses or perform certain procedures in this region. The procedure is comparatively gentle for the patient and nowadays is usually performed without anesthesia.

What is a bronchoscopy?

Bronchoscopy involves inserting an endoscope into the bronchial tubes, which allows the attending physicians to make accurate diagnoses or perform certain procedures in this region. By bronchoscopy, physicians mean the insertion of an endoscope into the human bronchi for diagnostic or treatment purposes. This procedure has been known since the end of the 19th century, although it was initially only used to remove foreign bodies. In bronchoscopy, a thin tube (called an endoscope) is inserted through the nose or mouth, down the trachea and into the bronchi. A camera can then be inserted to obtain an accurate picture of the condition of the bronchial tubes. Tissue samples can also be taken in this way. Whereas in the past mainly rigid endoscopes were used, today medicine relies on flexible devices. These are more versatile and also more comfortable for the patient to use. Because the endoscopes are only 2 – 3 mm in diameter, they can also be used on infants.

Function, effect and goals

Bronchoscopy can be used for a variety of purposes. In the case of diagnostic use, the procedure is performed to assess the condition of the bronchial tubes and/or to confirm or rule out disease. In particular, cancers of the lungs (lung tumors) can be reliably detected in this way. A biopsy, a sampling of tissue, can also be helpful in diagnosing various diseases. For this purpose, tiny surgical instruments are inserted into the bronchial tubes via the endoscope, which are operated externally by medical personnel trained for this purpose. These instruments are also used when bronchoscopy is performed for therapeutic purposes. For example, foreign bodies that have been accidentally inhaled can be removed (this is especially common in young children). Growths such as the so-called hematoma can also be removed with little effort with the help of bronchoscopy. If the patient is currently being artificially ventilated, the position of the tube required for this can be corrected during a bronchoscopy. The thin endoscope can also be easily inserted and subsequently removed during artificial respiration. The endoscope can also be used to flush the bronchial tubes if this is necessary due to excessive mucus formation. If there is cancer in the lung/bronchial area, bronchoscopy can also be used for local radiation therapy to increase the chances of cure. Whether a rigid or flexible endoscope is used for bronchoscopy depends on the individual purpose. Although flexible tubes are now primarily used, a rigid endoscope may be necessary in some circumstances, for example, to remove a foreign body, which is often difficult with a flexible tube.

Risks, side effects, and hazards

The potential risks of bronchoscopy lie primarily in the risk of injury to the patient. The use of rigid endoscopes in particular repeatedly causes injury to the sensitive mucosa, as they can bump against it and cause damage even when used very carefully. This results in bleeding, which can be more or less severe. Cramp-like reactions of the respiratory tract or larynx can also be triggered by bronchoscopy, especially with rigid equipment. In contrast, the risk of injury is rather low when using flexible endoscopes. In addition, the use of rigid endoscopes, which also have a larger diameter than their flexible variants, is perceived by patients as very uncomfortable. For this reason, bronchoscopies with rigid endoscopes are always performed under anesthesia. This involves certain risks, especially for patients with a previous illness, but anesthesia is also always a burden for completely healthy persons, and should be avoided if possible.Basically, however, bronchoscopy is a routine procedure in today’s world, leading to more severe complications only in very rare cases.