RT Journal Article
SR Electronic
T1 How successful are medical thoracoscopists at predicting non-expandable lung?
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA3098
DO 10.1183/13993003.congress-2021.PA3098
VO 58
IS suppl 65
A1 Syed Ajmal
A1 Sarah Johnstone
A1 Muhammad Tufail
A1 Rakesh Panchal
YR 2021
UL http://erj.ersjournals.com/content/58/suppl_65/PA3098.abstract
AB Introduction: Identification of non-expandable lung (NEL) at local anaesthetic thoracoscopy (LAT) with concurrent indwelling pleural catheter (IPC) insertion avoids a subsequent repeat procedure. However, NEL can be difficult to predict during LAT. In a UK survey only 12.5% of NEL was correctly predicted during LAT.1 We reviewed our practice of IPC insertion at LAT for suspected NEL.Method: Retrospective analysis of LAT procedures from 2014-2020. IPC was inserted if the physician deemed significant visceral pleural abnormality at LAT. NEL was correctly diagnosed if <50% pleural opposition/persistent hydropneumothorax (HPX) on chest radiograph 1 week post-LAT.Results: 51 dual LAT and IPC procedures. Mean age 70.9 years with 71% male. NEL was present in 41%. 59% had expanded lung (EL) with median duration to EL of 2 days. HPX was present in 38% with NEL prior to LAT compared to 10% in EL. 87% EL patients had IPCs removed compared to 43% with NEL. The main reason for IPC removal was autopleurodesis (71%). The median duration to IPC removal in autopleurodesis is 149 days in NEL compared to 56 days in EL.Conclusion: In our institution NEL prediction at LAT was 41%. HPX pre-LAT is 4 times more likely to indicate NEL and would benefit from concurrent IPC insertion. IPC was twice as likely to be removed in EL vs NEL. The duration to IPC removal for autopleurodesis was almost triple in NEL vs EL.References: 1. Hallifax RJ, et al. Medical thoracoscopy: Survey of current practice-How successful are medical thoracoscopists at predicting malignancy? Respirology. 2016 Jul;21(5):958-60.FootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA3098.This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.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).