title: The utility of thoracic ultrasound before local anesthetic video-assisted thoracoscopy in patients with suspected pleural malignancy.
abstract: Video-assisted thoracoscopy under local anesthesia (VAT-LA) is a key investigation in the diagnosis and management of suspected malignant pleural effusion. Two problems encountered at VAT-LA are accessing the pleural space and fibrinous intrapleural septa. Thoracic sonography (TUS) is known to facilitate thoracocentesis after dry tap but has not been studied in detail before VAT-LA. We report a case of lateral decubitus pre-VAT TUS that helped locate the optimal access to the pleural space and demonstrated fibrinous intrapleural septation, thereby affecting the decision to avoid thoracoscopic pleurodesis.
authors.affiliation: Department of Respiratory Medicine, Glenfield Hospital, Groby Road, Leicester LE3 9QP, Leicestershire, England, UK.
authors.forename: Andrew R L
authors.initials: AR
authors.lastname: Medford
mesh_terms: D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods*; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D035422:Pleural Cavity / Q000000981:diagnostic imaging* / Q000601:surgery; D010996:Pleural Effusion / Q000000981:diagnostic imaging* / Q000601:surgery; D013396:Suction; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography