Review of a 10-year experience of rigid bronchoscopy at a tertiary centre in Singapore

Abstract

Purpose: No report of rigid bronchoscopy (RB) has been described from Singapore. Methods: We did a retrospective review of medical records of patients undergoing RB between November 2009 and November 2019 at Tan Tock Seng Hospital. Results: 135 patients underwent 203 RB. RB was done for malignant central airway obstruction (MCAO) in 91 and benign diseases in 44 patients. The techniques used were Nd: YAG laser (n = 56), stenting (n = 63), transbronchial needle aspiration (n = 5), clot removal (n = 9), ballooning (n = 15), argon plasma coagulation (n = 5), and electrocautery (n = 37). Procedural complications occurred in three (2.2%). Median survival was 10.1 months (interquartile range [IQR], 2.2 to 45.3) in the whole group, 7.8 (IQR, 2 to 18.3) in MCAO and 42.6 (IQR, 8.9 to 77.5) in benign diseases respectively. Twenty-two (16.3%) patients requiring intensive care unit survived for 7.1 months (IQR, 1.6 to 9.8) after RB. Twenty-eight (21%) patients required repeat RB 68 times. Of these 34 (50%) were for granulation tissue removal. Conclusion: RB was safe and improved survival however, the demand was low. The most common indications were re-canalization of MCAO and granulation tissue removal. The later was the most resource consuming indication for repeat RB. Future research should focus on minimization of granulation tissue formation.