Flexible bronchoscopy in adults: Associated diagnostic and therapeutic procedures
- Shaheen Islam, MD, MPH, FCCP
Shaheen Islam, MD, MPH, FCCP
- Ohio State University Medical Center
Both diagnostic sampling and therapeutic interventions can be performed during flexible bronchoscopy. Common diagnostic and therapeutic procedures are reviewed in this topic. An overview of flexible bronchoscopy, indications, contraindications, complications, and technical aspects of the procedure are discussed separately. (See "Flexible bronchoscopy in adults: Overview" and "Flexible bronchoscopy in adults: Indications and contraindications" and "Flexible bronchoscopy in adults: Preparation, procedural technique, and complications".)
All patients should be consented for bronchoscopic airway inspection and for any pre-planned procedures. Consent, preparation, and the procedural details of airway inspection are discussed separately. (See "Flexible bronchoscopy in adults: Preparation, procedural technique, and complications".)
Many diagnostic procedures can be performed using a flexible bronchoscope with the aim of establishing a diagnosis of benign or malignant disease involving the airway (figure 1), parenchyma, and/or mediastinum. Typically airway inspection is coupled with one or more procedures.
Standard conventional white light bronchoscopy can be used for all of the diagnostic procedures discussed in this section. (See 'Endobronchial brushing' below and 'Bronchoalveolar lavage' below and 'Bronchial washing' below and 'Endobronchial biopsy' below and 'Transbronchial biopsy' below and 'Needle aspiration' below.)
Diagnostic procedures that can be performed with other types of flexible bronchoscopy are provided separately:
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- Choosing the type of procedure
- Endobronchial brushing
- Bronchoalveolar lavage
- Bronchial washing
- Endobronchial biopsy
- Transbronchial biopsy
- Needle aspiration
- Choosing the therapeutic procedure
- - Laser resection
- - Argon plasma coagulation
- - Photodynamic therapy
- - Electrocautery
- - Cryosurgery
- - Balloon dilatation
- - Brachytherapy
- - Airway stenting
- - Valve placement
- - Bronchial thermoplasty
- SUMMARY AND RECOMMENDATIONS