TY - JOUR T1 - Diagnostic utility of medical thoracoscopy in peripheral parenchymal pulmonary lesions JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P498 AU - Eman Hatata AU - Ahmed Youssef AU - Mohamed Zidan AU - Haytham Emam AU - Basma El-Saba Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P498.abstract N2 - Introduction: Visceral pleural biopsy and peripheral lung biopsy can be undertaken at the same time as parietal pleural biopsy during medical thoracoscopy, with or without coexistence of pleural effusion. Objective: To assess the accuracy and safety of medical thoracoscopy for the evaluation of peripheral parenchymal pulmonary lesions. Methods: We studied 15 patients with peripheral parenchymal pulmonary disease, the cause of which had not been determined after initial investigations, including needle biopsy and thoracocentesis if pleural effusion was present. We recorded clinical characteristics, laboratory data, findings and duration of thoracoscopy and any complications associated with the procedure. Results: A definitive diagnosis was established in 12 patients; 4 patients had primary bronchogenic carcinoma while 5 patients had metastases. Only 3 patients had benign parenchymal lung disease. Overall, thoracoscopy was 100% accurate with a sensitivity of 80%, a specificity of 100% for the diagnosis of peripheral parenchymal pulmonary lesions. Thoracoscopy was well tolerated under local anesthesia and entailed hospitalization for less than 48 hours in most cases. No deaths occurred, although 6.6% of patients had major complications, and 19.8% had minor complications.Conclusion: Among patients with peripheral parenchymal pulmonary lesions remaining undiagnosed after usual initial investigation and even transthorathic needle biopsies, thoracoscopy done under local anesthesia is a rapid, safe and well-tolerated procedure with an excellent diagnostic yield that is equivalent to that of thoracotomy. ER -