Pleuroscopy for diagnosis and therapy for pleural effusions.
Pleuroscopy, also known as medical thoracoscopy, is a minimally invasive procedure to inspect and perform a biopsy of the pleural space as well as to perform therapeutic interventions. It differs from conventional video-assisted thoracic surgery in that it may be performed under moderate sedation in the endoscopy suite without the need for intubation or single-lung ventilation. The diagnostic accuracy of this procedure approaches 100% in malignant and tuberculous pleural effusions. Complication rates are low (2%-5%) and are typically minor (subcutaneous emphysema, bleeding, infection), with mortality rates <0.1%. Therapeutic interventions, such as chemical pleurodesis, may be performed during pleuroscopy for recurrent, symptomatic malignant pleural effusions, with success rates approaching 90%. In trained hands, pleuroscopy is a safe and well-tolerated procedure with high diagnostic accuracy and therapeutic efficacy.
Interventional Pulmonology and Thoracic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, One Deaconess Rd, Deaconess 201A, Boston, MA 02215, USA. gmichaud@bidmc.harvard.edu
Gaetane
G
Michaud
David M
DM
Berkowitz
Armin
A
Ernst
D003937:Diagnosis, Differential; D006801:Humans; D010996:Pleural Effusion / Q000175:diagnosis* / Q000628:therapy*; D015203:Reproducibility of Results; D013906:Thoracoscopy / Q000379:methods*; D014741:Video Recording