PT  - JOURNAL ARTICLE
AU  - Chatura Wirasinghe
AU  - Duminda Yasarathne
AU  - Prasanna Wijerathene
AU  - Dushantha Madegedara
TI  - Use and comparison of a fiber optic bronchoscope as an alternative to a purpose built thoracoscope
DP  - 2012 Sep 01
TA  - European Respiratory Journal
PG  - P3357
VI  - 40
IP  - Suppl 56
4099  - http://erj.ersjournals.com/content/40/Suppl_56/P3357.short
4100  - http://erj.ersjournals.com/content/40/Suppl_56/P3357.full
SO  - Eur Respir J2012 Sep 01; 40
AB  - BackgroundMechanical failure of (fiber optic thoracoscope) FOT at our unit, which was an established investigation in pleural disease led to a search for an alternative.ObjectiveTo demonstrate the use of a fiber optic bronchoscope (FOB) for local anesthetic thoracoscopy and to compare it with a purpose build thoracoscope.MethodologyThe new procedure was similar to standard local anesthetic thoracoscopy with the difference being an 8mm internal diameter endotracheal tube used as the trochar thorough which FOB was inserted. 22 patients with undiagnosed unilateral plural effusion underwent the procedure from July to November 2011. Their results were compared to those obtained using purpose built FOT in 22 consecutive patients from January 2011.ResultsModified FOB thoracoscopy was successful in 77% of patients while purpose built FOT was successful in 86%. All failures were attributed to lungs not collapsing due to adhesions. Time taken to empty fluid from the pleural cavity and total procedure times were longer with FOB. The biopsy size using FOB was smaller. Histological diagnosis of malignancy was made in 27% (6) in FOB group and in FOT group it was 32% (7). Histological evidence of TB was obtained 22%(5) in FOB group and 27%(6) in the FOT group. A universal complication in both groups was post procedure pain which was relieved with use of simple analgesics. Other procedure related complications were not encountered in both groups.ConclusionA modified procedure with FOB can be used safely with a reasonable success rate to investigate pleural disease by experienced operators although there are limitations.