Complications and predictors of diagnostic yield of endobronchial forceps biopsy in visible lesions

Authors

  • Bishow Kumar Shrestha Chitwan Medical College Teaching Hospital, Bharatpur – 10, Chitwan, Nepal.
  • Shital Adhikari Chitwan Medical College Teaching Hospital, Chitwan, Nepal
  • Binay Kumar Thakur B P Koirala Memorial Cancer Hospital, Chitwan, Nepal
  • Dipen Kadaria University of Tennessee HSC, Memphis, TN, USA
  • Kishore Kumar Tamrakar Chitwan Medical College Teaching Hospital, Chitwan, Nepal
  • Mukti Devkota B P Koirala Memorial Cancer Hospital, Chitwan, Nepal

DOI:

https://doi.org/10.3126/jaim.v8i2.28002

Keywords:

Bronchoscopy, forceps biopsy, exophytic growth, predictors

Abstract

Background: Fiberoptic bronchoscopy is an important and relatively safe procedure for evaluation of various pulmonary diseases. Endobronchial forceps biopsy is commonly performed sampling technique for visible lesions in tracheobronchial tree. Diagnostic yield of biopsy depends upon lesion type and the number of biopsy samples taken. This study aimed to evaluate the complications and diagnostic yield of endobronchial forceps biopsy in visible lesions and correlate the number of biopsy samples taken with the yield.

Methods: This was an observational study conducted at two tertiary care hospitals in Chitwan; Chitwan Medical College Teaching Hospital and B P Koirala Memorial Cancer Hospital. One hundred and forty patients who underwent endobronchial forceps biopsy of bronchoscopically visible lesions were included. Complications and diagnostic yield of the biopsy samples and its correlation with number of biopsies taken were evaluated.

Results: The common complications observed were transient drop in saturation > 4% (22%) and mild bleeding (9.9%). The net diagnostic yield was 67.4% that significantly improved with an increase in the number of biopsies taken. The yield was better for exophytic growths compared to submucosal/ mucosal lesions (83.7% vs. 57%, OR = 8.1 (2.2 – 29.9), P<0.001). The association of improved yield with increased number of biopsy was more pronounced in exophytic growths compared to submucosal/mucosal lesions.

Conclusion: Endobronchial forceps biopsy is a safe procedure that gives a good diagnostic yield in bronchoscopically visible lesions, provided adequate number of biopsy sample are taken. The probability of getting a positive yield is high in exophytic growths.

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Author Biographies

Bishow Kumar Shrestha, Chitwan Medical College Teaching Hospital, Bharatpur – 10, Chitwan, Nepal.

Pulmonary, Critical Care and Sleep Medicine Unit

Shital Adhikari, Chitwan Medical College Teaching Hospital, Chitwan, Nepal

Pulmonary, Critical Care and Sleep Medicine Unit

Binay Kumar Thakur, B P Koirala Memorial Cancer Hospital, Chitwan, Nepal

Department of Thoracic Medicine

Dipen Kadaria, University of Tennessee HSC, Memphis, TN, USA

Division of Pulmonary, Critical Care and Sleep Medicine

Kishore Kumar Tamrakar, Chitwan Medical College Teaching Hospital, Chitwan, Nepal

Department of Surgery

Mukti Devkota, B P Koirala Memorial Cancer Hospital, Chitwan, Nepal

Department of Thoracic Surgery

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Published

2019-12-31

How to Cite

Shrestha, B. K., Adhikari, S., Thakur, B. K., Kadaria, D., Tamrakar, K. K., & Devkota, M. (2019). Complications and predictors of diagnostic yield of endobronchial forceps biopsy in visible lesions. Journal of Advances in Internal Medicine, 8(2), 21–25. https://doi.org/10.3126/jaim.v8i2.28002

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Section

Original Articles