Transbronchial Biopsy: Our Experience in 5 Year

Objective: Transbronchial biopsy (TBB) is an old diagnostic method applied via fiberoptic bronchoscopy. The diagnostic value and complication rate of the procedure were found to vary in previous studies. In present study, the diagnostic value of TBB was analysed.
Methods: All medical files of 308 patients who underwent TBB between May 2010-May 2015 in our clinic were reviewed retrospectively. According to the final diagnoses, the diagnostic value and complication rates of TBB, the contribution of the additional samples of the same bronchoscopic session to the diagnoses, and the requirement of any additional invasive procedure were investigated.
Results: Of all the patients, 63% were female and the mean age was 51 (17-85). Bronchoalveolar lavage was taken in 257 patients. Ten percent of the procedures could not reach lung parenchyma. TBB was diagnostic in 105 (34%) patients. Fifty (16%) patients were diagnosed via other samples of the same session, 15 (5%) resolved spontaneously, 28 (9%) were diagnosed via other clinical findings, 41 (14%) did not accept further invasive method or were lost-to follow-up. Sixty-nine (22%) underwent an additional invasive procedure. The most frequent final diagnosis was sarcoidosis and the diagnostic value of TBB was 49%. Diagnostic rate of TBB was lower in fibrotic interstitial lung diseases (ILD) and malignancy whereas higher in non-fibrotic ILD. No mortality was seen related to TBB, pneumothorax was seen in 6%; non-massive bleeding in 3%, respiratory failure in 0.3%.
Conclusion: Transbronchial biopsy is a procedure having a higher diagnostic value in certain diseases and has an acceptable morbidity. When combined with other bronchoscopic samples, the need for further invasive methods decreases significantly.