A STUDY INTO THE DIAGNOSTIC YIELD OF FIBER-OPTIC BRONCHOSCOPY AT RURAL MEDICAL COLLEGE IN THE POST COVID ERA

Introduction: Thefiber-optic bronchoscopy (FOB) has become an integral and essential part of respiratory medicine as diagnostic, therapeutic and interventional modality due to advancement that has occurred during last five decades. FOB facilitates direct visualization of centrally located lung pathology and the biopsies can also be procured from lung parenchyma. The diagnostic yield is variable and depends upon available resources and skill. Material and Method: 241 cases of FOB that were performed in post Covid-19 era were evaluated for diagnostic yieldat RD Gardi Medical College hospital, Ujjain, India. Results: 230 cases of FOB done for the diagnosis were considered for study after exclusion of 11 casesin which FOB was performed for therapeutic or other reason. The male predominance was found with > 80% in the patients belonging to age group of 41 yrs and above. The diagnostic yield remained at 82.6% including the inflammatory malignancy, bacterial TB and fungal infection which were 36.3%, 33.7%, 17.9, 7.4% and 3.2 % respectively. Discussion: The clinical, radiologic, and pathologic investigations are prerequisite and determine the indication to perform endoscopy for further evaluation and it helps in selecting procedure during FOB. The gross abnormalities are not always seen but TBLB, TBNA and inflammatory cytology of BAL definitely helpful in diagnostic yield. The minor complications during and post procedure are not uncommon. Occasionally the anatomical variations and anomalies of the airways can also be detected during FOB. Conclusion: The FOB enables to procure tissue and secretions from the airways and also facilitates evaluation of lung parenchyma for diagnosis of underlying pathology. The advancement in multifunctional utility of FOB, supported with basic knowledge of guidelines, with expertise and skill is required for better outcomes.