Source: Annual Congress 2007 - Pleural techniques and diagnosis of peripheral lung nodules
Disease area: Respiratory infections, Thoracic oncology

Abstract

Introduction:
Pleural diseases pose a significant challenge to respiratory physicians. The diagnostic yield of blind pleural biopsy is very poor and video assisted thoracoscopic surgery requires general anaesthesia. Rigid thoracoscopy is promising but remains underutilised (Mathur, PN. J Bronchol 2004; 11: 147-149)
Objectives:
Previously we presented semirigid thoracoscopy data on 60 patients with medium to large unilateral pleural effusions (Munavvar, M et al. Eur Respir J 2007; in press). We now report our extended experience in 100 patients, including more complex and smaller pleural effusions/thickening.
Methods:
Semirigid thoracoscopy using the proto-type instrument (LTF-160Y1; Olympus, Tokyo, Japan) was attempted on 100 patients with undiagnosed pleural effusion/thickening between June 2004 and January 2007. Pre-procedure computed tomography was performed in all cases. Therapeutic drainage and talc poudrage was done where appropriate.
Results:
Ninety four successful procedures were performed. Samples were taken in 90 cases (inadequate in 5 cases) without any significant complications. In 5 other cases diagnosis was achieved after additional investigations. The instrument had good manoeuvrability and excellent views.

Final diagnosis (n:80)

Mesothelioma	Lung cancer	Metastatic cancer	Normal pleura	Tuberculosis	Other benign conditions	Positive yield
19	17	12	7	4	21	89%

Conclusions:
Semirigid thoracoscopy provides an exciting and effective new approach for the management of pleural diseases with comparable results to rigid thoracoscopy. The instrument design is compatible with existing equipment in bronchoscopy suites and its design is similar to the flexible bronchoscope, which makes it additionally attractive.

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Citations should be made in the following way:
M. Hasan, A. Khan, J. Mills, M. Munavvar (Preston, United Kingdom). Semirigid thoracoscopy in the real world – an experience with 100 patients. Eur Respir J 2007; 30: Suppl. 51, 732

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