Flexible bronchoscopy contribution in the approach of diagnosis and treatment of children’s respiratory diseases: the experience of a unique pediatric unit in Tunisia

Samia Hamouda, Amal Oueslati, Imen Belhadj, Fatma Khalsi, Faten Tinsa, Khadija Boussetta

Abstract

Objective: Our study aimed at assessing the role of flexible bronchoscopy (FB) in improving diagnosis and management of children’s respiratory conditions in the pediatric unit of FB, newly created and unique in Tunisia.

Methods: Retrospective study including all the FB achieved in our pediatric unit from 2009 to 2014.

Results: We performed 365 FB in 333 patients aged 46 months on average (1 month – 15 years), often under conscious anesthesia (81.6%). FB was performed for diagnostic purposes in 341 cases and for therapeutic purposes in 24 cases. Eight anatomical abnormalities were revealed in 22 patients. An intraluminal bronchial obstruction was found in 71 FB, mainly due to a foreign body (n=36). A vascular anomaly was responsible for nine cases out of 17 extraluminal obstructions. Airways malacia was observed in 60 FB. Bronchoalveolar lavage was performed in 196 cases. It was determinant in 43.9% of the cases. FB was of great diagnostic value in 74.8% of the cases. It influenced the management of the patients in 58% of the cases. The FB for therapeutic purposes was beneficial in all cases. Few complications occurred (5.5%).

Conclusion: FB is a safe tool providing precious diagnostic and/or therapeutic help for the clinician.

Keywords: Flexible bronchoscopy, child, bronchoalveolar lavage, foreign body aspiration, pulmonary alveolar proteinosis