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Radiol Oncol. 2014 Jan 22;48(1):67-71. doi: 10.2478/raon-2013-0068. eCollection 2014 Mar.

Semirigid thoracoscopy: an effective method for diagnosing pleural malignancies.

Author information

1
Endoscopy and Pulmology Department, University Clinic Golnik, Slovenia.
2
Intensive Care Department, University Clinic Golnik, Slovenia.
3
Pathology Department, University Clinic Golnik, Slovenia.
4
Pulmology Department, University Clinic Golnik, Slovenia.

Abstract

BACKGROUND:

Thoracoscopy with a semirigid instrument is a recent technique for diagnosing pleural diseases. The purpose of this study was to report diagnostic yield and complications of the method.

PATIENTS AND METHODS:

Patients with pleural effusion of unknown origin and/or pleural irregularities suspicious for pleural malignancy were included after less invasive means of diagnosis had failed. All procedures were performed under local anaesthesia with intravenous sedation/analgesia with a single point of entry with a semirigid thoracoscope (Olympus LTF-160). Data were collected prospectively between 2008 and 2012.

RESULTS:

One hundred fifteen thoracoscopies were performed on 111 patients. The median age was 65 years (range 28-86 years), 14.4% were female and 85.6% male. Seventy-three (65.8%) patients had malignant pleural disease (malignant mesothelioma, metastatic cancer) and 38 (34.2%) had benign disease. The sensitivity, negative predictive value, and accuracy of the procedure for malignancy were 96.0%, 93.0%, and 97.4% respectively. Pleurodesis was carried out in 34 patients; in 32 (94.1%) it was assessed as successful after 1 month. There were 24 adverse events: three empyemas/pleural infections, three bronchopleural fistulae after chest tube placement and lung re-expansion, five patients had excessive pain after pleurodesis, six patients had sedation-associated hypotension, and seven patients had self-limited fever after plerodesis. One patient died 11 days after a procedure for advanced carcinoma.

CONCLUSIONS:

Semirigid thoracoscopy is an accurate and safe method for evaluation of pleural diseases and useful for therapeutic talc pleurodesis.

KEYWORDS:

flex-rigid pleuroscopy; pleural biopsy; pleural effusion; safety; thoracoscopy

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