Implementation of rigid bronchoscopy safety protocols in lung cancer diagnosis

<bold>Introduction:</bold> Rigid bronchoscopy as a standalone or in combination with flexible bronchoscopy can be applied in lung cancer (LC) diagnosis. The use of standardized management protocols ensures patients safety Aim:To review the clinical efficiency of standardised rigid bronchoscopy safety protocols in LC diagnosis. Materials and Methods: Retrospective case review of rigid bronchoscopies performed for LC diagnosis under standard operating protocols. <bold>Results:</bold> 526 rigids were performed with anaesthetic cover (2012-2023). Mean age 66.3 years (age range 34-81 years),397 males. 71.37% rigids were performed for LC diagnosis. Cases were referred through MDT after flexible bronchoscopy assessed high haemorrhaghic risk resistant to systemic measures. Diagnostic pathology confirmation included 32 carcinoids,221 adenocarcinomas,251 squamous cell carcinomas,22 large cell carcinomas. 17 cases were admitted overnight due to frailty and increased ASA, the rest were day cases. Mean procedure time:42 mins. Rigid bronchoscopy safety checklist was applied prior to the procedure (5 pillars–equipment, operator, patient, staff, anaesthetist),followed by preoxygenation, laryngoscope visualization, rigid. Electrocautery was used for haemorrhagic control(24 cases). All patients were offered a chestXray 4-6h post procedure and rigid bronchoscopy safety discharge checklist was applied for safe discharge on same day (6 pillars; samples, oxygenation, mobilization, dizziness, muscle strength, shortness of breath). Significant events, morbidity and 28d mortality were 0. Conclusions: Safety protocols applied in rigid bronchoscopy ensure a seamless diagnostic daycase procedure with minimal morbidity/mortality supporting patient safety standards.