The determination of diagnostic yield and complication rate of the fiberoptic bronchoscopy procedure

Background: Fiberoptic bronchoscopy (FOB) is an invasive procedure that allows direct visualization of the airways and is widely used in the diagnosis and treatment of pulmonary diseases. Although various sampling techniques such as bronchoalveolar lavage, cytology, and biopsy can be performed during FOB, its diagnostic yield remains variable in the literature depending on lesion characteristics and the method used. Therefore, determining the real-world diagnostic effectiveness of FOB is important. The aim of this study was to evaluate the diagnostic yield of FOB procedures performed in our clinic. Materials and Methods: This retrospective, descriptive, and analytical study was conducted using data from adult patients who underwent FOB at the Department of Chest Diseases, Faculty of Medicine, Çukurova University, between January 1, 2019 and December 31, 2023. Patients with complete bronchoscopy reports and available pathology, cytology, and microbiology results were included. During FOB, bronchoalveolar lavage, endobronchial biopsy, transbronchial biopsy, and cytological sampling were performed. Descriptive statistics were used to analyze demographic characteristics, bronchoscopic findings, diagnostic yields, and the most frequently established diagnoses. Results: Data from a total of 499 patients meeting the inclusion criteria were analyzed; the median age was 65.0 years. Bronchoscopic sampling was most frequently performed in the right upper lobe, while a substantial proportion of patients had no visible endobronchial lesion. Histopathological examination yielded a diagnosis in 63.3% of patients who underwent biopsy, whereas the diagnostic yield of cytological evaluation was 31.1%. Microbiological analysis identified an etiological agent in 53.9% of cases, providing diagnostic contribution. Conclusion: This study demonstrated that FOB provides a high diagnostic yield, particularly through histopathological samples obtained by biopsy, while cytological and microbiological examinations play a complementary role. In clinical practice, the combined and targeted use of bronchoscopic sampling techniques is recommended to enhance diagnostic success. Keywords: Biopsy, Fiberoptic bronchoscopy, Cytology, Microbiological examination