PURPOSE: To survey the current state of respiratory endoscopy application and complications, the Japan Society for Respiratory Endoscopy performed a nationwide questionnaire survey employing the mailing method.
METHODS: The survey form was mailed to all facilities certified by the society, 538 facilities in total. The subjects were patients who underwent respiratory endoscopy in 2010. The actual states of cases were surveyed using an inventory, in which the numbers of applications, complications, and deaths were investigated by lesion and procedure.
RESULTS: The inventory was collected from 483 facilities (89.8%). The number of diagnostic flexible bronchoscopy applications was 103,978, and 4 patients died (0.004%). The complication rate by lesion ranged from 0.51 to 2.06%, and that in patients with diffuse lesions was the highest. The complication rate by procedure ranged from 0.17 to 1.93%, and that in patients who underwent forceps biopsy was the highest. The complication rate after forceps biopsy of solitary peripheral pulmonary lesions was 1.79% (hemorrhage: 0.73%, pneumothorax: 0.63%), and that after Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) of hilar and/or mediastinal lymph node lesions was 0.46% (pneumonia and/or pleuritis: 0.22%, mediastinitis and/or pericarditis: 0.08%). Therapeutic bronchoscopy was performed in 3,020 cases, and one patient died of metal stent insertion-induced hemorrhage (0.03%). By procedure, the complication rate after foreign body removal was the highest (2.2%). Medical Pleuroscopy was performed in 1,563 cases, and a semi-flexible pleuroscope was used in most cases. The complication rate after biopsy using no electrocautery was the highest (1.86%). Two hundred and twenty-eight facilities experienced breakage of bronchoscopes and/or devices.
CONCLUSIONS: Respiratory endoscopy was safely performed, but education concerning complications caused by new techniques is necessary.
CLINICAL IMPLICATIONS: A nationwide survey investigated the numbers of complications, and deaths by lesion and procedure for respiratory endoscopy in 2010. Investigation of the frequency of complications associated with respiratory endoscopy is necessary for not only medical care safety, but also providing information to patients.
DISCLOSURE: The following authors have nothing to disclose: Fumihiro Asano, Motoi Aoe, Yoshinobu Ohsaki, Yoshinori Okada, Shinji Sasada, Shigeki Sato, Eiichi Suzuki, Hiroshi Senba, Shozo Fujino, Kazumitsu Ohmori
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