Current status of diagnostic and therapeutic bronchoscopy in Japan: 2016 national survey of bronchoscopy

Respir Investig. 2019 May;57(3):238-244. doi: 10.1016/j.resinv.2018.12.007. Epub 2019 Feb 6.

Abstract

Background: The safety management committee of the Japan Society for Respiratory Endoscopy (JSRE) conducted national surveys to clarify the state of diagnostic and therapeutic bronchoscopy in 2016.

Methods: Questionnaire forms were mailed to 532 JSRE-accredited facilities throughout Japan. We surveyed the actual condition of clinical practice and cases of bronchoscopy during 2016.

Results: Four hundred and thirty-three facilities responded giving a response rate of 81.4%; 67.6% held more than 400 beds. The average number of board accredited senior Fellows and Fellows per facility was 1.9 and 3.2, respectively. Diagnostic bronchoscopy was performed in a hospitalized setting in 74.6% of all facilities. The radial type ultrasound probe was operated in 51.7% of all facilities. The number of facilities has markedly increased compared with that reported in the 2010 survey (19.6%). The bronchoscopic navigation system had been in operation in 41.7% of all facilities. Antithrombotic drugs were adjusted before biopsy in 96.8% of all facilities. For intravenous sedation, midazolam was the first choice in 76.9% of all facilities. Endobronchial ultrasound guided transbronchial lymph node needle aspiration (EBUS-TBNA) has become popular over the decade (19.6% in 2010 to 68.1% in 2016). The mean number of the board accredited senior Fellows and board accredited Fellows increased in comparison with that in 2010. As a new technique, radial type ultrasound-guided peripheral approach has become popular.

Conclusions: Through this survey, the advanced safety of bronchoscopic examination has been secured in many facilities. A continuous monitoring of bronchoscopic practices with respect to safety management is recommended.

Keywords: Diagnostic bronchoscopy; Guide sheath method; Radial type endobronchial ultrasound; Virtual navigation bronchoscopy; bronchoscopy safety.

MeSH terms

  • Accreditation / statistics & numerical data
  • Bronchoscopy / methods
  • Bronchoscopy / statistics & numerical data*
  • Conscious Sedation
  • Cross-Sectional Studies
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration / statistics & numerical data
  • Female
  • Fibrinolytic Agents / administration & dosage
  • Humans
  • Japan / epidemiology
  • Lymph Nodes / pathology
  • Male
  • Midazolam / administration & dosage
  • Safety
  • Safety Management / statistics & numerical data*
  • Surveys and Questionnaires
  • Time Factors

Substances

  • Fibrinolytic Agents
  • Midazolam