PURPOSE: To determine the complication rate from supervised training bronchoscopy in a single pulmonary fellowship program, and to examine the effects of fellow and faculty experience on this complication rate.
METHODS: A retrospective review of pre-existing quality improvement data from one center for the time period of July 1, 1991 until June 30, 2005 was performed. Data was stratified based on the fellow year group and staff experience level. The types of complications were recorded.
RESULTS: A total of 3,538 training bronchoscopies were performed during the study period with 73 complications for a complication rate of 2.06%. The most common complication was pneumothorax. Overall complication rates for first year fellows, second year fellows, and third year fellows were not significantly different from the total complication rate. Training bronchoscopies supervised by junior staff had a complication rate not significantly different from that of senior staff. The cumulative first trimester complication rate for first year fellows was 3.1%, whereas the cumulative second plus third trimester complication rate for first year fellows was 1.57% (p<0.05).
CONCLUSION: Training bronchoscopy during a pulmonary fellowship is a safe procedure in a supervised setting. Novice bronchoscopists have an increased complication rate during the first trimester of training.
CLINICAL IMPLICATIONS: Close supervision of novice bronchoscopists is needed in clinical training programs. The impact of new training methods, including simulation techniques, on outcomes from training bronchoscopies should be investigated.
DISCLOSURE: Daniel Ouellette, None.