This study aims to compare the diagnostic yield of bronchoalveolar lavage (BAL) using a thick conventional bronchoscope and bronchial washing (BW) using a thin bronchoscope in the diagnosis of pulmonary tuberculosis.
In patients with suspected pulmonary tuberculosis (TB), confirm the presence of TB bacilli through sputum testing is essential for diagnosis. However, the sensitivity of sputum specimens is suboptimal, and some patients may be unable to produce sputum. In such situations, it is traditionally known that obtaining samples through bronchoscopy increases the diagnostic yield of pulmonary TB. Typically, the method of using a thick, conventional bronchoscope to perform bronchial washing (BW) or bronchoalveolar lavage (BAL) is commonly employed. However, a drawback of the conventional bronchoscope is its inability to reach close to peripheral pulmonary TB lesions due to its larger diameter. Recent studies have reported an increased diagnostic yield for pulmonary TB when using a thin bronchoscope for BW compared to using a thick, conventional bronchoscope for BW. However, a direct comparison with the method of performing BAL (BAL may have a higher diagnostic yield compared to BW) using a conventional bronchoscope has not been conducted. This study aims to prospectively compare the diagnostic yield for pulmonary TB between BAL using a conventional bronchoscope and BW using a thin bronchoscope.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
SINGLE
Enrollment
132
For intervention, we plan to perform bronchial washing using a thin bronchoscope instead of bronchoalveolar lavage with the conventional thick bronchoscope to diagnose pulmonary TB.
Pusan National University Hospital
Busan, South Korea
RECRUITINGTB detection rate
Positivity rate of Xpert MTB/RIF assay in BAL or BW fluid
Time frame: within 2 weeks of bronchoscopy
Mycobacterium tuberculosis culture
Positivity rate of Mycobacterium tuberculosis culture in BAL or BW fluid
Time frame: within 8 weeks of bronchoscopy
AFB(acid-fast bacilli) smear
Positivity rate of AFB smear in BAL or BW fluid
Time frame: within 2 weeks of bronchoscopy
Adverse event
Adverse event related/unrelated to bronchoscopy
Time frame: within 2 weeks of bronchoscopy
Time to treatment
Time to treatment (TB treatment commencing date - bronchoscopy date, day) in participants with confirmed TB
Time frame: within 8 weeks of bronchoscopy
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