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Clinical Investigations: PLEURA |

A Novel Instrument for the Evaluation of the Pleural Space*: An Experience in 34 Patients

Armin Ernst, MD, FCCP; Craig P. Hersh, MD; Felix Herth, MD; Robert Thurer, MD, FCCP; Joseph LoCicero, III, MD, FCCP; John Beamis, MD, FCCP; Praveen Mathur, MD, FCCP
Author and Funding Information

*From the Divisions of Pulmonary and Critical Care Medicine (Drs. Ernst, Hersh, and Herth) and Thoracic Surgery (Drs. Thurer and LoCicero), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; the Division of Pulmonary and Critical Care Medicine (Dr. Beamis), Lahey Clinic, Burlington, MA; and the Division of Pulmonary and Critical Care Medicine (Dr. Mathur), Indiana University, Indianapolis, IN.

Correspondence to: Armin Ernst, MD, FCCP, Director, Interventional Pulmonology, Pulmonary and Critical Care Division, Beth Israel Deaconess Medical Center, Harvard Medical School, One Deaconess Rd, Boston, MA 02115;



Chest. 2002;122(5):1530-1534. doi:10.1378/chest.122.5.1530
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Study objectives: To test a novel semirigid pleuroscope to be used by pulmonologists for the diagnosis and treatment of pleural diseases.

Design: Prospective study.

Setting: Three tertiary referral centers for pulmonary diseases.

Patients: Thirty-four patients who were referred for medical thoracoscopy between September 2000 and April 2001.

Measurements and results: Thirty-six procedures were performed. The most common indications were for pleurodesis of a malignant pleural effusion (53%) or for evaluation of an exudative effusion of unknown etiology (44%). All operators found the instrument easy to use. In all but one case, the images were thought to be adequate, despite the presence of adhesions in 12 patients and loculations in 8 patients. Pleural biopsies were performed in 13 patients, and talc pleurodesis procedures were performed in 25 patients. Mean (± SD) duration of chest tube drainage was 2.9 ± 1.8 days postprocedure. There were no complications.

Conclusions: The prototype semirigid pleuroscope is a useful instrument in the diagnosis and management of pleural diseases. It is similar in design to a standard flexible bronchoscope, so the skills involved in operating the instrument should already be familiar to the practicing pulmonologist. It is compatible with existing video processors and light sources, so little additional equipment must be added to the endoscopy suite. The semirigid pleuroscope may allow for an increase in the performance of medical thoracoscopy by pulmonologists.

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