31622 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)

Name of the Procedure:

• Bronchoscopy, rigid or flexible
• Diagnostic Bronchoscopy with Fluoroscopic Guidance and Cell Washing

Summary

Bronchoscopy is a procedure that allows doctors to view the inside of the airways and lungs. A thin tube with a camera (bronchoscope) is inserted through the nose or mouth, down the throat, and into the lungs. The procedure can be done using a rigid or flexible bronchoscope and may include fluoroscopic guidance—an imaging technique that helps guide the bronchoscope. During the procedure, doctors can collect cell samples by washing the airways with a saline solution.

Purpose

• Diagnose lung diseases, infections, or blockages causing symptoms like persistent cough, wheezing, or abnormal chest X-rays.
• Collect cell samples to analyze for infections, cancer, or other lung conditions.
• Assess airway conditions and guide treatments like removing foreign objects or tumor biopsies.

Indications

• Unexplained or persistent cough
• Abnormal chest X-ray or CT scan
• Suspected lung infection or tumor
• Airway blockages or breathing difficulties
• Chronic respiratory symptoms

Preparation

• Fasting for at least 6-8 hours before the procedure.
• Adjusting medications as advised (e.g., blood thinners may need to be paused).
• Pre-procedure assessments like blood tests, chest X-rays, or spirometry.

Procedure Description

1. The patient is positioned and given a sedative or anesthetic.
2. A bronchoscope is inserted through the nose or mouth, passing through the throat and into the lungs.
3. Fluoroscopic guidance may be used to help navigate and locate specific lung areas.
4. A saline solution is used to wash the airways, and the fluid is collected for cell analysis.
5. Additional diagnostic or therapeutic steps (e.g., biopsies) may be performed if needed.
6. The bronchoscope is carefully removed.

Duration

• Typically takes about 30 to 60 minutes.

Setting

• Usually performed in a hospital or specialized outpatient clinic.

Personnel

• Pulmonologist (lung specialist) or thoracic surgeon
• Anesthesiologist or nurse anesthetist
• Nurses and respiratory therapists

Risks and Complications

• Common risks: temporary sore throat, hoarseness, minor bleeding.
• Rare risks: pneumonia, lung collapse (pneumothorax), severe bleeding, allergic reactions to sedatives.
• Complications are usually manageable with prompt medical attention.

Benefits

• Accurate diagnosis of lung conditions.
• Direct visualization of airways for targeted treatment.
• Immediate cell sample analysis, leading to timely intervention.

Recovery

• Patients can usually go home the same day.
• Mild throat discomfort or coughing may persist for a few days.
• Avoid strenuous activities for 24 hours following the procedure.
• Follow-up appointments to discuss findings and any further treatment.

Alternatives

• Chest X-rays or CT scans: non-invasive but less detailed.
• Sputum tests: less invasive sample collection but may be less accurate.
• Needle biopsy: minimally invasive but carries a risk of complications like pneumothorax.

Patient Experience

• Discomfort from the sedative or anesthetic during and after the procedure.
• Mild sore throat, coughing, or hoarseness after the procedure.
• Pain management could include over-the-counter pain relievers and throat lozenges.
• Most patients report minimal discomfort and quick recovery.