A novel instrument for the evaluation of the pleural space: an experience in 34 patients.
OBJECTIVE
To test a novel semirigid pleuroscope to be used by pulmonologists for the diagnosis and treatment of pleural diseases.


METHODS
Prospective study.


METHODS
Three tertiary referral centers for pulmonary diseases.


METHODS
Thirty-four patients who were referred for medical thoracoscopy between September 2000 and April 2001.


RESULTS
Thirty-six procedures were performed. The most common indications were for pleurodesis of a malignant pleural effusion (53%) or for evaluation of an exudative effusion of unknown etiology (44%). All operators found the instrument easy to use. In all but one case, the images were thought to be adequate, despite the presence of adhesions in 12 patients and loculations in 8 patients. Pleural biopsies were performed in 13 patients, and talc pleurodesis procedures were performed in 25 patients. Mean (+/- SD) duration of chest tube drainage was 2.9 +/- 1.8 days postprocedure. There were no complications.


CONCLUSIONS
The prototype semirigid pleuroscope is a useful instrument in the diagnosis and management of pleural diseases. It is similar in design to a standard flexible bronchoscope, so the skills involved in operating the instrument should already be familiar to the practicing pulmonologist. It is compatible with existing video processors and light sources, so little additional equipment must be added to the endoscopy suite. The semirigid pleuroscope may allow for an increase in the performance of medical thoracoscopy by pulmonologists.
Ernst
Armin
A
Divisions of Pulmonary and Critical Care Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA. aernst@caregroup.harvard.edu
Hersh
Craig P
CP
Herth
Felix
F
Thurer
Robert
R
LoCicero
Joseph
J
Beamis
John
J
Mathur
Praveen
P
D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010995:Pleural Diseases / Q000175:diagnosis*; D011446:Prospective Studies; D020708:Thoracoscopes