Bronchoscopy

A bronchoscopy is a procedure to examine the windpipe (trachea) and large airways of the lungs (bronchi). It is done using a bronchoscope, which is a type of endoscope. Doctors most often use a flexible bronchoscope that can bend to reach further inside the lungs. In rare cases, a rigid bronchoscope that is straight and stiff may be used.

A bronchoscopy is done to both diagnose and treat certain lung problems. It is done to:

• look for lung infections, disease or cancer
• get tissue samples so that a pathologist can look at them under a microscope
• help stage lung cancer
• see if a lung tumour can be removed by surgery
• find out why someone is coughing up blood, and control it
• remove objects that shouldn’t be there from the airway
• remove fluid, mucus or polyps
• drain pus that has collected (called an abscess) or a cyst in the lung
• evaluate damage to the airway caused by trauma

A bronchoscope may also be used during some other diagnostic tests or cancer treatments so that the doctor can see the airways and lungs.

A bronchoscopy is done in a hospital operating room as an outpatient, so you can usually go home the same day. You may be sleepy after the test is done, so someone will need to drive you home.

Your healthcare team will tell you how to prepare for a bronchoscopy. You will be told to not eat or drink anything for 6 to 12 hours before the test. Tell your healthcare team about all prescription and non-prescription medicines you are taking. You will need to take dentures out if you have them.

If you are having a flexible bronchoscopy, the healthcare team may give you a drug to help you relax during the procedure. A local anesthetic is used to relax the throat muscles and numb the mouth, throat or nasal passages. If the local anesthetic is sprayed in the throat, it can taste bitter and might make your tongue feel thick. It’s normal to want to cough or gag.

The flexible bronchoscope is put through the mouth or nose, down the throat, through the windpipe and large airways of the lungs, and then the lungs. The bronchoscope can also be inserted through a special tube that is placed in your throat to keep the breathing passages clear during surgery (called an endotracheal tube) or tracheostomy.

While the bronchoscope tube is being inserted you may feel pressure or tugging. You will be able to breathe, but it may feel like you can’t. If you are uncomfortable during the test, let your doctor know.

For a rigid bronchoscopy you will be given a general anesthetic, which means you will be asleep during the procedure.

The doctor examines the airways of the lung and takes tissue samples during the procedure. Sometimes a salt (saline) liquid will be put through the bronchoscope. This flushes out the lungs, and samples of cells from inside the tiny air sacs of the lungs (alveoli) can be collected.

A bronchoscopy usually takes between 30 and 60 minutes. You will be in the recovery room for 1 to 3 hours after it is done.

You can’t eat or drink anything for a few hours after a bronchoscopy. You will need to wait until you can swallow without choking. Your throat may feel sore and scratchy for a few days after the procedure.

Side effects can happen with any procedure. They are rare after a bronchoscopy but may include:

• bleeding
• infection
• having trouble breathing
• low levels of oxygen in the blood
• contraction of the muscles in the bronchi (bronchospasm)
• collapsed lung
• irregular heartbeat
• heart attack (usually in people with heart problems)

An abnormal result may mean that:

• there is cancer in the lung or bronchi
• the windpipe or airways are blocked
• cancer has spread to the lymph nodes

The doctor will decide whether you need further tests, procedures, follow-up care or more treatment.

Being prepared for a test or procedure can reduce anxiety, increase cooperation and help the child develop coping skills. Parents and caregivers can help prepare children by explaining to them what will happen, including what they will see, feel, hear, taste or smell during the test.

Preparing a child for a bronchoscopy depends on the age and experience of the child. Find out more about helping your child cope with tests and treatments.