RT Journal Article SR Electronic T1 Evaluation of medical thoracoscopy in high risk surgical patients at Basildon Hospital JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP p594 VO 38 IS Suppl 55 A1 N. Banerjee A1 A. Elsheikh A1 D.K. Mukherjee YR 2011 UL http://erj.ersjournals.com/content/38/Suppl_55/p594.abstract AB Background: Medical thoracoscopy can reliably achieve a diagnosis in pleural effusions of unknown origin outside the operating theatre with less morbidity. Yields are comparable to the gold standard of VATS pleural (video assisted thoracoscopic surgery)biopsy.Aims: This study aims to evaluate the diagnostic accuracy and safety of medical thoracoscopy in high risk surgical patients at our centre.Method: Records of patients undergoing medical thoracoscopy between Jul '07–Jan '11 (n=53) were analysed retrospectively for surgical risk by ASA (American Society of Anaesthesiologists) physical status classification, diagnosis and complications.Results: Surgical risk. 46 (86%) were identified as high risk surgical candidates by ASA criteria. 39 (84%) patients had severe systemic disease that limited function (ASA 3) and 7 (15%) had severe systemic disease that was a constant threat to life (ASA 4).Diagnosis. Histological diagnosis (sensitivity) was achieved in 51 (96%) and diagnostic accuracy (specificity) in 45 (88%). The results were – non small cell lung cancer 6 (11%), malignant mesothelioma 14 (27%), chronic pleuritis 26 (50%), metastatic cancer 3 (5%), small cell lung cancer and pulmonary TB - 1 each (2%). 7 (13%) cases with chronic pleuritis had further investigations. 5 had VATS biopsy (mesothelioma -3, sarcoidosis -1, benign pleuritis -1), 1 CT biopsy (non small cell lung cancer) and 1 bone biopsy (metastatic cancer).Complication. Persistant air leak and surgical emphysema in 2 (3%) cases were managed conservatively. No life threatening complication was recorded.Conclusion: Our experience with this procedure, highlights the safety and efficacy of medical thoracoscopy even in in high risk surgical patients.