Pleuroscopy or medical thoracoscopy is a minimally invasive procedure that has been used as diagnostic and therapeutic procedures for pleural diseases. There were few medical centers in Thailand performing this procedure. We review our outcome of pleuroscopy in Siriraj Hospital.
Pleuroscopy with rigid thoracoscope was performed under local anesthesia and conscious sedation. There were 4 indications for pleuroscopy in our center, undiagnosed pleural effusion, empyema, pleurodesis and pneumothorax.
189 procedures of pleuroscopy had been performed between January 1998 and March 2009. In group of undiagnosed pleural effusion (120 patients), the overall diagnostic yield was 95.8%. The malignancy was diagnosed in 45.8%. In group of empyema (18 patients), fever was resolved after pleuroscopy in all patients and mean length of hospital stay was 10.5 days after procedure. For indication of pleurodesis (44 patients), the success rate of pleurodesis with talc poudrage was 78.6%. The major reasons for early failure of pleurodesis in 9 patients (21.4%) were trapped lung (7 patients) and extensive pleural adhesion (2 patients). The mean length of hospital stay was 5.5 days. Seven patients underwent pleuroscopy due to indication of pneumothorax. Talc poudrage was done in all patient with success rate of 85.7%. There was no major complication from all procedures.
Pleuroscopy is a safe procedure and can be used as diagnostic and therapeutic procedures with high diagnostic yield and success rate of pleurodesis.
Pleuroscopy is a safe and effective procedure for management of pleural diseases.
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