E. Barbeta*a (Dr), J. Tarregaa (Dr), Y. Galeaa (Dr), A. Molaa (Dr)

a Hospital General de Granollers Universitat Internacional de Catalunya, Granollers, SPAIN

* ebarbeta@fphag.org

Pleuroscopy, also known as thoracoscopy under local anaesthesia is a useful technique in the diagnosis and treatment of pleural effusions. The development of a semi-rigid thoracoscope, similar in design to the flexible bronchoscope, can implement this technique in the departments of pneumology and improve the performance in the management of pleural disease.

AIM: to describe the results of the pleuroscopies performed in a general hospital during the last 12 years, using the OLYMPUS LTF-160 semiflexible thoracoscope The pleuroscopys were performed under local anaesthesia and conscious sedation in an area of ​​endoscopy.

242 patients (mean age 65 years) underwent to pleuroscopy, in 170 cases for diagnosis and 72 for pleurodesis. Were 113 diagnoses of malignancy (78 carcinomatous pleurisy, 28 mesotheliomas, 4 lymphomas, 2 sarcoma and 1 melanoma) 4 patients were false negative (2 mesothelioma and 2 carcinomas). The specificity for malignancy was 100% and sensitivity 96%. In 5 patients with bronchogenic carcinoma and 1 with carcinoma of urinary tract, pleural metastasis was discarded. Were 10 tuberculosis pleurisy, 3 empyema and 38 nonspecific pleuritis. 149 pleurodesis with talc (Steritalc Novatech) were performed, the median survival of 71 deceased patients was 156 days.

Complications of the technique have been: 7 cases of subcutaneous emphysema, 3 case of infection stitch, 6 case of persistent air leak and 1 empyema

1 - The pleuroscopy with semi-flexible thoracoscope is a safe, minimally invasive technique, with high performance diagnostic and therapeutic indications.

2 - The realization of this technique under local anaesthesia and conscious sedation in endoscopy rooms simplifies and speeds up the diagnostic process of diseases of the pleura.

3 - The availability of this semi-rigid thoracoscope should facilitate the implementation of this technique in respiratory endoscopy units and increase the efficiency of pulmonologists in the management of pleural pathology.

Disclosure of funding source(s): none