FIBEROPTIC BRONCHOSCOPY AND ITS PATHOLOGIC FINDINGS AMONG PATIENTS ATTENDED CHEST UNIT AT ST. PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE IN ADDIS ABABA, ETHIOPIA: AN EIGHT YEARS RETROSPECTIVE PATIENTS’ RECORD REVIEW

Abstract

Abstract Background: Respiratory diseases among adult people in developing countries are a major cause of morbidity and mortality. Symptoms related to respiratory tract diseases negatively affect quality of life and inflict a significant economic impact majorly in low income countries. Fiberoptic bronchoscopy is currently regarded as the standard approach for evaluating the tracheobronchial tree and for therapeutic interventions with minimally invasive options. However, there is limited local data on indication for bronchoscopy evaluations and common underlying pathologies. Objective: To assess the main indications for fiberoptic bronchoscopy and its pathologic findings among patients presented to chest clinic from 2013 to 2021, at Saint Paul’s Hospital Millennium Medical College in Addis Ababa. Methods: A hospital based retrospective patients’ record review was conducted among 61 patients who had undergone bronchoscopy evaluation from January 2013 to 2021, at Saint Paul’s Hospital Millennium Medical College. A structured checklist was used to screen records for completeness. Data were entered, cleaned and analyzed using SPSS version 25. A descriptive analysis was done using frequencies, means and percentages. The findings were summarized in tables, graphs, figures and words accordingly. Results: A total of 61 patients who underwent a complete bronchoscopy evaluation were found in the study period. The mean age was 46 years. Suspected malignancy was the common indication for bronchoscopy in most of the cases (65.4%) followed by infection 27%. Abnormal bronchoscopy findings were seen in 85% of the cases with most of the pathologies in the right main bronchus. Nonspecific mucosal abnormalities were found in 48%, extrinsic airway compression in 36.5% & endobronchial mass in 15.4%. Thirty-four patients had biopsy, 4 had no intervention and 55 patients had BAL. Twenty-one malignancies found in this study and squamous cell carcinoma constitutes 35.3%. Of those 10 patients whose Genexpert results were available, 6 patients were diagnosed as a case of M. tuberculosis. There was no major complication during procedure in this study. Conclusion & Recommendations: Suspected malignancy was found to be the most common indication for FOB. It was noted that diagnostic yield is high when histopathology coupled with cytology. Bronchoscopy remains a safe procedure and emphasis should be given on improving access to this service. Starting procedural training (sub specialty) in SPHMMC will greatly improve the management of pulmonary patients. Key Words: Fiberoptic bronchoscopy indications, pathologic findings, Saint Paul’s Hospital Millennium Medical College, Ethiopia