Abstract
Introduction: Medical thoracoscopy(MT), using flexirigid thoracoscope(FRT) or conventional rigid thoracoscope(CRT) is increasingly being used for performing pleural biopsies, therapeutic adhesiolysis and talc poudrage. Biopsies with FRT are small and lack sufficient depth and those with CRT are larger but requires larger incision and is more painful. Mini-rigid thoracoscopes(MRT) combine advantages of FRT and CRT but, with scarce data on their performance.
Aims: To evaluate performance of MRT(4mm telescope and 6mm trocar) for MT.
Methods: A single centre retrospective observational study on patients undergoing MT using MRT over 3 years conducted at Yashoda hospitals, Hyderabad. Procedures were done under conscious sedation and intercostal nerve block in bronchoscopy suite. Pleural biopsies(atleast 6) were obtained when indicated. Adhesiolysis, talc poudrage were performed if necessary.
Results: Of the 220 patients who underwent MT using the MRT, parietal pleural biopsies were obtained in 206 patients. Procedural yield (ability to obtain pleural tissue) and diagnostic yield (ability to obtain a final histologic diagnosis) were 100% and 90.78%, respectively. Most common diagnosis was tuberculosis(n=85) followed by malignancy(n=62), synpneumonic effusion(n=24), others(n=16), non specific pleuritis (n=19). Therapeutic adhesiolysis was performed successfully in 103 patients. Talc poudrage was done in 18 patients. Complications: airleak (n=6), re expansion pulmonary edema (n=3). No mortality attributable to the procedure.
Conclusion: MRT is safe and effective with procedural yield of 100% and diagnostic yield of 90.78%. MRT Can also be used for therapeutic ahdesiolysis and talc poudrage.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA3125.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019