title: Safety of interventional bronchoscopy through complication review at a cancer center.
abstract: OBJECTIVE
  There have been rapid advances in the area of interventional bronchoscopy over the past 15 years, but associated complications have been rarely discussed. A longitudinal evaluation of the same operator's performance at a cancer center is reported.
  
  
  METHODS
  A detailed record review of diagnostic and therapeutic bronchoscopy between January 1997 and March 2013 was conducted.
  
  
  RESULTS
  Among the 1358 diagnostic bronchoscopies, there were nine major complications requiring premature termination and three pneumothoraces found during follow-up (0.88%). An escalation in the level of care was required for four patients with massive bleeding, asthma attack, sedation intoxication and myocardial ischemia, respectively. Six cases occurred after brushing (0.71%), and five cases before any sampling procedure was conducted. The complication rate was highest for peripheral lesions (1.03%). Among the 109 therapeutic bronchoscopies, no major patient-specific complication occurred except for excessive granulation tissue formation following metallic stenting in one patient with benign tracheal stenosis.
  
  
  CONCLUSIONS
  The complication rate with regard to bronchoscopy is comparable with historical controls according to the related literature, and their occurrence appears to be sporadic, not relevant to patient characteristics and mostly related to the bronchoscopy itself rather than the introduction of new techniques. Bronchoscopy remains safe along with technical innovations. However, risk recognition and effective prevention is essential.
authors.affiliation: Department of Medicine, National Yang-Ming University Medical School, Taipei, Taiwan.|Division of Pulmonary and Critical Care Medicine, Sun Yat-Sen Cancer Center, Taipei, Taiwan.
authors.forename: Li-Han
authors.initials: LH
authors.lastname: Hsu
authors.affiliation: Division of Thoracic Surgery, Sun Yat-Sen Cancer Center, Taipei, Taiwan.
authors.forename: Chia-Chuan
authors.initials: CC
authors.lastname: Liu
authors.affiliation: Department of Pathology, Sun Yat-Sen Cancer Center, Taipei, Taiwan.
authors.forename: Jen-Sheng
authors.initials: JS
authors.lastname: Ko
authors.affiliation: Division of Cardiology, Sun Yat-Sen Cancer Center, Taipei, Taiwan.
authors.forename: Chao-Chun
authors.initials: CC
authors.lastname: Chen
authors.affiliation: Department of Research, Sun Yat-Sen Cancer Center, Taipei, Taiwan.
authors.forename: An-Chen
authors.initials: AC
authors.lastname: Feng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001999:Bronchoscopy / Q000009:adverse effects / Q000706:statistics & numerical data*; D002648:Child; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000473:pathology; D012189:Retrospective Studies; D055815:Young Adult
keywords: bronchoscopy; complications; interventional bronchoscopy; safety