Pleuroscopy with semi-flexible Pleura thoracoscope
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