Are repeated bronchoscopies with tissue sampling safe for patients with pulmonary lesions?

"When conducting repeated tissue sampling on patients who once bled, it should be treated with discretion," Liyan Boa from the Second Affiliated Hospital of Air Force Medical University, Xi'an, PR China, and colleagues wrote in their study.

Many patients require repeated bronchoscopies with tissue sampling to get the final pathological results and to guide the optimal subsequent pulmonary lesions treatment. Considering that not many studies have explored the safety of repeated biopsies, the research team set out to determine the safety of repeated biopsies in patients with pulmonary lesions.

For this purpose, the researchers revised the records of patients who underwent bronchoscopy-guided tissue sampling due to pulmonary lesions between n 1 January 2008 and 31 December 2019 at the respiratory department. Clinical characteristics, information on bronchoscopy and the occurrence of complications in patients were collected and analyzed.

The study led to the following findings:

• A total of 3899 bronchoscopy-guided tissue sampling procedures were conducted in the 1781 participants.
• As was the hemoptysis, there was no remarkable difference in the prevalence of major complications between the initial and repeated bronchoscopies (1.12% vs 1.13%).
• The authors found a significantly higher bleeding rate in patients who got bleeding during the first bronchoscopies compared to patients who did not experience bleeding (61.19% vs. 32.63%).

"Re-bronchoscopy with tissue sampling for patients with pulmonary lesions infers the same bleeding risk, comprising severe bleeding as observed during the initial bronchoscopy. However, it should be treated with discretion when conducting repeated tissue sampling on patients who once bled," the authors concluded.

Reference:

Li C, Li Y, Jin F, Bo L. The bleeding risk and safety of repeated bronchoscopies with tissue sampling in patients with pulmonary lesions. Expert Rev Respir Med. 2022 Dec 18:1-6. doi: 10.1080/17476348.2022.2159382. Epub ahead of print. PMID: 36529971.