TY - JOUR T1 - The management of pleural disease with the rigid and semirigid thoracoscopes JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P495 AU - Ilias Porfyridis AU - Frangiskos Frangopoulos AU - Georgios Georgiadis AU - Paris Vogazianos AU - Charis Charalampous AU - Andreas Georgiou Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P495.abstract N2 - Introduction: Medical thoracoscopy(MT) with the rigid (RT) or the semirigid (ST) thoracoscopes is a useful technique for the investigation of pleural disease.Aim: To compare the diagnostic accuracy and the endoscopic performance(EP) of the two instruments.Methods: Patients with pleural effusions, further investigated with MT were enrolled in the study. MT was performed under local anaesthesia using the RT(STORZ, Germany) and the ST(Olympus, Japan) in each patient from the same point of entry. Biopsies from the same areas were obtained with ST and RT biopsy forceps. The final histopathological diagnoses were recorded. Two experienced thoracoscopists assessed the EP (ease of manoeuvring, taking biopsies, inspecting the pleural cavity) scoring each instrument using a scale from 0(inability to perform the procedure) to 5(optimal performance).Results: Twenty six patients were enrolled in the study. The diagnostic accuracy was 92%(24 of 26cases) for the RT and 84%(22 of 26) for the ST(p=0.44). The final diagnoses were: malignant mesothelioma(n=6), metastatic lung cancer(n=4), tuberculosis(n=1), benign asbestos exposure(n=1), parapneumonic effusions(n=7) and non specific pleuritis(n=5). MT could not be performed in two cases (one loculated empyema, one malignant mesothelioma). One patient with malignant mesothelioma had a false(-) biopsy with the ST. Mean±SD EP score was 3.8±1.2 for the RT and 4.1±1.5 for the ST(p=0.18). There were no major complications.Conclusion: The RT and ST were accurate for the diagnosis of pleural disease. ST performed better in cases with uncomplicated pleural effusions. RT performed better in cases with loculated pleural effusions, adhesions or maligmant mesothelioma. ER -