RT Journal Article
SR Electronic
T1 Evaluation of medical thoracoscopy (MT) service at Basildon Hospital, UK
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P489
VO 44
IS Suppl 58
A1 C. Nadarajah
A1 R. Mogal
A1 A. Kaur
A1 D. Mukherjee
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P489.abstract
AB Background:The current British Thoracic Society guidelines 2010 recommend the use of MT for cytology negative,exudative pleural effusions,by using local anaesthesia and conscious sedation.Aims:To evaluate the outcomes of MT and success of talc pleurodesis (TP) following MT.Methods:A retrospective analysis of 118 patients that underwent MT.Successful pleurodesis was defined as no evidence of pleural fluid re-accumulation on a follow up chest X-ray 30 days post procedure.The instrument used was a Richard Wolf GmbH rigid 7mm thoracoscope with a 4mm for biopsy.TP was performed using Steritalc spray.Results:Out of 118 patients,28 patients were excluded from analysis (20 patients had lack of data and in 8 patients procedure was abandoned).The avergae age of patients was 76 years.83.3% of patients had abnormal pleura (n=75).Endoscopic findings of malignant pleural involvement were mostly nodules of varying size and thickened pleura.The pathological diagnoses were as follows:primary pleural mesothelioma 36.7%(n=33),pleural metastases 28.9%(n=26),non-specific chronic inflammation 13.3%(n=12),hepatic hydrothorax 2.2%(n=2),Tuberculosis pleurisy 1.1%(n=1),and empyema 1.1%(n=1).66.7% of patients had pleurodesis (n=60) and it was successful in 71.70% of patients (n=43).12.2% of patients had complications (n=11) that included pain(n=2),trapped lungs(n=5),wound infections (n=2),skin haematoma (n=1),and surgical emphysema(n=1).The average length of stay was 3.7 days but in patients with complications it was 5.6 days.Conclusion:MT is a relatively safe procedure for the diagnosis of patient with an exudative pleural effusion.Serious complications are rare,however,complications led to prolonged hospital stay,and therefore cost.