Bronchoscopy
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What is the
test?
A bronchoscope is a long snakelike instrument
with a tiny video camera and biopsy instruments
on one end. It can be maneuvered through your
mouth and directly into the airways of your lungs.
Bronchoscopy is usually done to obtain a sample
of deep lung mucus or lung tissue to help diagnose
cancer, pneumonia, or other lung disease.
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How
do I prepare for the test?
You will need to sign a consent form giving
your doctor permission to perform this test.
Some patients have this test done in a clinic
procedure area, while others are admitted to
the hospital for it. Generally your doctor will
decide whether you need to be in the hospital
based on your medical condition. If you are not
staying in the hospital afterward, you should
arrange for a ride home.
Talk with your doctor ahead of time if you are
taking insulin, or if you take aspirin, nonsteroidal
antiinflammatory drugs, or other medicines that
affect blood clotting. It may be necessary to
stop or adjust the dose of these medicines before
your test. Most people need to have a blood test
done some time before the procedure to make sure
they are not at high risk for bleeding complications.
Also tell your doctor if you have ever had an
allergic reaction to the medicine lidocaine or
the numbing medicine used at the dentist's office.
Usually you will be told not to eat anything
after midnight on the night before the test.
This is so you will have an empty stomach in
case you experience nausea from anti-anxiety
medicines (sedatives) or have a choking sensation
or nausea when the camera is first lowered past
your throat.
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What
happens when the test is performed?
You wear a hospital gown during the procedure.
You have an IV (intravenous) line inserted into
a vein in case you need medicines or fluid during
the procedure.
In some cases, your doctor decides that this
procedure would be safer or easier if you were
intubated before the test and for a short time
afterward. This means having a plastic tube placed
through your mouth into your main airway. If
you are intubated, you are able to breathe, but
you cannot speak while the tube is in place,
as it passes between your vocal cords in your
voice box. Intubation is always done with the
assistance of an anesthesiologist, who gives
you medicines to relax your throat muscles and
make you unconscious for a minute or two while
the tube is placed. Most patients do not require
intubation.
If you are not intubated, your doctor or nurse
sprays a numbing medicine onto the back of your
throat just before the procedure. This medicine
makes it easier for you to have the bronchoscope
placed. Most patients are also given some medicine
through the IV to relax them.
You lie on a hospital bed for the procedure.
Your doctor (usually a pulmonary specialist)
moves one end of the bronchoscope through your
mouth and throat and into your trachea (windpipe).
Some patients cough or gag briefly when this
is done. The bronchoscope is much narrower than
your trachea, so you are able to breathe easily
during the procedure.
The doctor can see into your lungs by watching
a TV screen that shows the view from the camera
on the end of the bronchoscope. Your doctor can
control a miniature vacuum at the end of the
scope that allows him or her to take a sample
of mucus from inside the lung. It is also possible
for the doctor to take a biopsy sample of the
lung tissue using a needle that can be moved
through the scope. At the end of the test, the
bronchoscope is pulled out, and you might cough
forcefully a few times, possibly coughing out
some phlegm.
Bronchoscopy usually takes 30 minutes to an
hour, including setup time. The camera is usually
in place for less than 20 minutes.
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What
risks are there from the test?
The risks of bronchoscopy are primarily associated
with the needle biopsy procedure that is sometimes
done through the bronchoscope. If a biopsy is
done, the risks include bleeding in the lung
or the formation of an air leak. If a patient
vomits during the procedure and stomach contents
leak down around the bronchoscope, this can irritate
the lung and cause a type of pneumonia called
aspiration pneumonia. Some patients have a hoarse
voice or a sore throat for a day or two after
bronchoscopy. Most people have no side effects
from the procedure.
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Must
I do anything special after the test is over?
You will probably feel sleepy after the procedure
for a few hours, due to the anti-anxiety medicines.
Generally, patients either spend a few hours
in a recovery room or stay overnight in the hospital
after bronchoscopy. If you do go home the same
day, you should not drive or drink alcohol.
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How
long is it before the result of the test is
known?
Your doctor can tell you what the airways in
your lungs look like as soon as the test is over.
If a sample of mucus or lung tissue was obtained,
analysis will require anywhere from a few hours
to a few days.
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