الفهرس | Only 14 pages are availabe for public view |
Abstract Bronchoscopy is a procedure to visualize the tracheobronchial tree the flexible fiberoptic bronchoscopy FOB, has greatly enhanced the diagnosis and understanding of lung diseases, and has evolved into the most commonly used diagnostic procedure in pulmonary medicine. Several medical centers all over the world have discussed their experience with the diagnostic yield of FOB, with controversial results. FOB not only helps in assessing the disease area but also provides better bacteriological and histological yield thus helping to reach a definite diagnosis. Therefore, the aim of this thesis was to study the indication and outcome of flexible fiberoptic bronchoscope in bronchoscopy unit, in Abassia Chest Hospital in the period from October 2013 to September 2014. This study included two hundred patients 156 (78.0%) males and 44 (22.0%) females with a mean age of (53.5 ± 14.3). As regards smoking habits 122 patient (61.0%) were smokers while 78 patients (39.0%) were non smokers. which reflect a higher prevalence of smoking as risk factors in males.As regards the clinical presentations 92 (46.0%) of cases had one presentation while 108 (54.0%) had many. Cough was the commonest presenting symptom in this study 147 (73.5%), dyspnea 113 (56.5%), chest pain 55 (27.5%), while haemoptysis was the least frequent clinical presentation 23 (11.5%). In half of the patient 101 (50%) a mass could be detected in their radiological finding followed by consolidation representing 63 (31.0%), lymphadenopathy in 50 (25.0%), effusion in 38 (19.0%), nodule in 32 (16.0%), collapse in 19 (9.5%), cavity in 14 (7.0%), while abscess was the least frequent finding representing in 9 (4.5%). The provisional diagnosis upon which the FOB was indicated comprised of 134 (67%) of cases with suspected malignancy followed by 30 (15%) of cases with suspected infection other than TB, suspected pulmonary T.B 22 (11.0%), while haemoptysis was the least frequent indication 12 (6.0%). This study reported yields of 80 (40.0%) among 200 patients. The most frequent yield of final diagnosis according to cytology, histopathology and bacteriology could be achieved by bronchial biopsy (60.0%), followed by bronchial lavage (33.7%), while brush was the least frequent yield (6.3%). Using the fiber optic bronchoscope in the diagnosis of malignancy was achieved in 53 (26.5%) of patients while the diagnosis of the infections was reached in 27 (13.5%), however in (60.0%) of the cases other methods were used to establish the accurate diagnosis. Majority of cases did not experience any complications. Bleeding and severe hypoxia occurred in minority of cases 3 patients (1.5%). |