title: Medical thoracoscopy.
abstract: The burden of pleural diseases continues to rise and affects an increasingly complex and aging patient population. As such, thoracentesis is one of the most common procedures performed by respiratory physicians, as pleural fluid analysis can establish the diagnosis of pleural effusions in approximately 75% of the cases. When a diagnosis is not reached, options include image-guided biopsies, only possible when focal pleural lesions can be identified by computed tomography or ultrasound; closed pleural biopsies, associated with a relatively low diagnostic yield; and surgical pleural biopsies, which typically require general anesthesia and a hospital stay. Medical thoracoscopy addresses some of the limitations of these techniques, allows a comprehensive pleural examination and targeted pleural biopsies, and offers the possibility of treatment of recurrence in the same setting. As such, medical thoracoscopy is ideally positioned as a valuable tool in the diagnosis of unexplained exudative pleural effusions.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Skalski
authors.affiliation: Department of Thoracic Oncology, Pleural Diseases, and Interventional Pulmonology, Hôpital Nord, Aix-Marseille University, Chemin des Bourrely, France.
authors.forename: Philippe J
authors.initials: PJ
authors.lastname: Astoul
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Fabien
authors.initials: F
authors.lastname: Maldonado
mesh_terms: D001706:Biopsy; D003937:Diagnosis, Differential; D006801:Humans; D010995:Pleural Diseases / Q000175:diagnosis* / Q000473:pathology*; D016066:Pleural Effusion, Malignant / Q000175:diagnosis / Q000473:pathology; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects / Q000379:methods; D013906:Thoracoscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*