A Novel Instrument for the Evaluation of the Pleural Space

Ernst, Armin; Hersh, Craig P.; Herth, Felix J.F.; Thurer, Robert L.; LoCicero, Joseph; Beamis, John F.; Mathur, Praveen N.

doi:10.1378/chest.122.5.1530

Cited by 88 publications

(69 citation statements)

References 7 publications

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“…This has been quoted as a reason for the former's superiority. However, smaller biopsy size does not necessarily translate to inferior diagnostic yield; indeed, the present authors' results, as well as those of other operators, have been excellent [3,15]. The fact that the instrument used can be autoclaved is a huge bonus and it opens the way for its wider use both in the UK and abroad.…”

Section: Discussionsupporting

confidence: 50%

“…After thoracocentesis and/or blind pleural biopsy, ,25-40% of pleural abnormalities remain undiagnosed [1,2]. Medical thoracoscopy refers to the examination of the pleural space in a nonintubated patient under conscious sedation [3]. It enables inspection of the pleural surfaces, the taking of pleural biopsies under direct vision, therapeutic drainage of effusions and pleurodesis in one sitting.…”

mentioning

confidence: 99%

“…The semirigid thoracoscope was developed in an attempt to combine the best features of the flexible and rigid instruments [3]. However, the use of this instrument in the UK has not been possible as it requires sterilisation with ethylene oxide, the use of which is not allowed in the UK.…”

mentioning

confidence: 99%

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The autoclavable semirigid thoracoscope: the way forward in pleural disease?

Munavvar¹,

Khan²,

Edwards³

et al. 2007

European Respiratory Journal

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Medical thoracoscopy is a valuable tool in the investigation and management of pleural disease. It has considerable advantages over conventional blind pleural biopsy and videoassisted thoracoscopic surgery. Despite this, the practice of this technique in the UK is limited. Most operators use the rigid thoracoscope, which may be an unfamiliar instrument to respiratory physicians. A semirigid thoracoscope is available but its use has not been possible in the UK as it requires sterilisation with ethylene oxide, which is not approved in this country. The present authors describe herein their experience with the first ever autoclavable semirigid thoracoscope.Medical thoracoscopy using the new instrument was performed in 56 patients between June 2004 and May 2006. All patients had been referred with a unilateral pleural effusion of unknown aetiology, where blind pleural aspiration had failed to yield an answer. Diagnostic samples were taken and talc poudrage performed where appropriate.The instrument was easy to handle and excellent views were obtained. Histologically adequate biopsy samples were obtained in 54 patients. The combination of clinical features, computed tomography findings and thoracoscopic biopsy enabled a definite diagnosis in 49 (90.7%) of these patients. There were no complications.The autoclavable semirigid thoracoscope has immense potential in the diagnosis and management of pleural disease. Its diagnostic yield in pleural disease is comparable to the conventional rigid thoracoscope. It is similar in design to the fibreoptic bronchoscope and respiratory physicians should be able to adapt to its use easily. It is also compatible with existing video processors and light sources available in most endoscopy suites. The fact that this instrument is autoclavable should open the field for its use in the UK as well as in other countries.

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Section: Discussionsupporting

confidence: 50%

mentioning

confidence: 99%

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The autoclavable semirigid thoracoscope: the way forward in pleural disease?

Munavvar¹,

Khan²,

Edwards³

et al. 2007

European Respiratory Journal

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“…A flexible bronchoscope has been used for thoracoscopy [10,11], and, more recently, a dedicated semi-rigid thoracoscope was developed [12]. Compared with rigid instruments, the control of the working end of the flexible thoroscope is limited due to its flexibility.…”

Section: Equipment For Thoracoscopymentioning

confidence: 99%

Thoracoscopy: general overview and place in the diagnosis and management of pleural effusion

Rodríguez-Panadero

Janssen²,

Astoul³

2006

European Respiratory Journal

152

111

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“…6 In malignant pleural diseases only 40 to 60% of patients have positive Abrams needle biopsy 3 and around 75% in patients with tuberculosis. 4 In another study the diagnostic yield of closed pleural biopsy by Abrams needle is only 50 to 60% in cases of pleural malignancies, Contrary to pleural fluid aspiration and percutaneous biopsy, pleuroscopy allows biopsy with direct visualization. Pleuroscopy is usually performed after one or two thoracocentesis and at least one closed percutaneous biopsy which is non diagnostic.…”

Section: Discussionmentioning

confidence: 96%

EXUDATIVE PLEURAL EFFUSION; Comparison of diagnostic yield between pleuroscopic and closed percutaneous pleural biopsies in patients

Saifullah¹,

Baig²,

Soomro³

et al. 2016

TPMJ

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ABSTRACT… Objectives:To compare the pleuroscopic and closed pleural biopsy by Abrams needle in terms of diagnostic yield and obtaining specific diagnosis in cases of exudative pleural effusion. Study Design: Cross sectional study. Period: August 2014 to February 2015. Setting: Department of Thoracic Medicine Jinnah Post Graduate Medical Center Karachi. Methodology: All patients with pleural effusion who were admitted and fulfilling the inclusion criteria were included in the study .Closed pleural biopsy using Abrams needle followed by pleuroscopy with a flexible pleuroscope was performed from the same incision, in the same sitting. The samples were sent for histopathology. To control bias samples were coded as A and B and the code was not known to the histopathologist. Results: Among 60 patients, Mean age was 42.85 years with ±18.2 standard deviation and male to female ratio was 1.6 :1. Specific diagnosis through pleuroscopic biopsy had shown 27 (45%) cases of tuberculosis, 25 (41.7%) of adenocarcinoma, 5 (8.3%) of chronic non specific inflammation, one (1.7%) case of lymphoma and 2 (3.3%) cases could not be reached for any diagnosis. Conclusion: Pleuroscopy has better yield than the Abrams needle biopsy in terms of both diagnostic yield and specific diagnosis Key words:Pleuroscopy, Abrams biopsy, pleural effusion and biopsy.

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A Novel Instrument for the Evaluation of the Pleural Space

Cited by 88 publications

References 7 publications

The autoclavable semirigid thoracoscope: the way forward in pleural disease?

The autoclavable semirigid thoracoscope: the way forward in pleural disease?

Thoracoscopy: general overview and place in the diagnosis and management of pleural effusion

EXUDATIVE PLEURAL EFFUSION; Comparison of diagnostic yield between pleuroscopic and closed percutaneous pleural biopsies in patients

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