title: Rigid versus semi-rigid thoracoscopy for the diagnosis of pleural disease: a randomized pilot study.
abstract: OBJECTIVE
  Thoracoscopy with a semi-rigid instrument is a recent technique successfully used for diagnosing pleural diseases. However, there are concerns about the diagnostic adequacy of biopsy samples obtained by semi-rigid procedures when compared with rigid thoracoscopy. The purpose of this study was to compare the size, quality and diagnostic adequacy of biopsy specimens obtained at semi-rigid and rigid thoracoscopy in a prospective, randomized fashion.
  
  
  METHODS
  Patients with pleural effusion of unknown origin and/or pleural irregularities suspicious for pleural malignancy were included after less invasive means of diagnosis had failed. All procedures were performed under local anaesthesia with intravenous sedation/analgesia with a single point of entry. Patients were randomly assigned to a rigid instrument procedure (Olympus EndoEYE WA50120A, forceps) or semi-rigid instrument procedure (Olympus LTF-160, FB-55CR-1 forceps).
  
  
  RESULTS
  Eighty-four patients were randomized. Five of them were excluded because of lack of pleural space. Thirty-eight patients were assigned to a rigid and 41 to a semi-rigid procedure, with mean follow up 24.1 (±8.1) months after the procedure. The average size of the sample obtained by rigid thoracoscopy was 24.7 mm(2) (±12.9), and 11.7 mm(2) (±7.6) by semi-rigid thoracoscopy. There were no differences in the quality and interpretability of the specimens assessed by the pathologist. The diagnostic accuracy was 100% for the rigid procedure and 97.6% for the semi-rigid procedure.
  
  
  CONCLUSIONS
  The samples obtained by semi-rigid thoracoscopy were smaller, but of adequate quality. The diagnostic accuracy was comparable with that of rigid thoracoscopy in the evaluation of pleural disease.
authors: Endoscopy Department, University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia. ales.rozman@klinika-golnik.si
authors: Ales
authors: A
authors: Rozman
authors: Luka
authors: L
authors: Camlek
authors: Mateja
authors: M
authors: Marc-Malovrh
authors: Nadja
authors: N
authors: Triller
authors: Izidor
authors: I
authors: Kern
mesh_terms: D000328:Adult; D000368:Aged; D000772:Anesthesia, Local; D016292:Procedural Sedation; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D010995:Pleural Diseases / Q000175:diagnosis* / Q000473:pathology; D011446:Prospective Studies; D016037:Single-Blind Method; D013906:Thoracoscopy / Q000295:instrumentation* / Q000379:methods*