Local Anaesthetic Thoracoscopy for Pleural Effusion—A Narrative Review

Li, Dana; Jackson, Karl; Panchal, Rakesh; Aujayeb, Avinash

doi:10.3390/healthcare10101978

Cited by 6 publications

(3 citation statements)

References 56 publications

(108 reference statements)

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“…This allows suction of fluid (large volumes of fluid can be removed after equalisation of the pleural pressure to the atmospheric pressure without the risk of re-expansion pulmonary oedema), and passage of a zero-degree camera initially for visual inspection of the pleura and then of the biopsy forceps over a fifty-degree camera for targeted biopsies. Talc poudrage with atomisers can be performed post-biopsies and a chest drain, usually large bore (more than 20 French gauge), or increasingly indwelling pleural catheters can be then inserted [ 3 , 6 , 16 ]. Some centres admit patients afterwards, others offer a day case service with same day discharge [ 17 ].…”

Section: What Does the Lat Procedures Involve?mentioning

confidence: 99%

Use of medical thoracoscopy in managing pleural malignancy

Aujayeb,

Astoul

2024

Breathe

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Local anaesthetic “medical” thoracoscopy is an important tool for the diagnosis and management of a unilateral pleural effusion. It is performed under conscious sedation and has a high diagnostic yield. Clinical experience has demonstrated that thoracoscopy is a safe procedure. This article is an expert review of various aspects of the procedures from two experienced practitioners and we suggest areas for potential future research.

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Section: What Does the Lat Procedures Involve?mentioning

confidence: 99%

Use of medical thoracoscopy in managing pleural malignancy

Aujayeb,

Astoul

2024

Breathe

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“…Patients with lung cancer who have exudative pleural IIIB. [24][25][26] The pleuroscopy procedure conducted on the patient with lung cancer revealed the presence of a tumor that exhibits a high susceptibility to bleeding.…”

Section: Pleuroscopy In Lung Cancermentioning

confidence: 99%

Flexi-rigid Pleuroscopy in Diagnostics of Malignancy: A Narrative Literature Review

Salmiyah,

Indra Yovi

2023

Bioscmed

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Pleuroscopy is a less invasive treatment that allows access to the pleural cavity with the use of both visual and surgical equipment. This technique can be conducted with local anesthesia and mild sedation. Pleuroscopy is a medical procedure used for both diagnosis and treatment in the pleural cavity. Pleuroscopy enables direct observation of the pleural surface, enhancing the safety of procedures such as pleural biopsy, pleural fluid drainage, and pleurodesis. One purpose is to assist in verifying the diagnosis of cancer. This review was aimed to describe the use of flexi-rigid pleuroscopy in malignancy.

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“…Thoracoscopy has traditionally been performed under general anaesthesia; however, methods for performing the procedure under local anaesthesia have recently been established [ 1 , 2 ], and many medical institutions in Japan are now performing thoracoscopies under local anaesthesia [ 3 ]. Because thoracoscopies can be performed under local anaesthesia, they are often performed by chest physicians.…”

Section: Introductionmentioning

confidence: 99%

Single-centre observational study of the safety and efficacy of thoracoscopy under local anaesthesia for the management of thoracic infections

Fujita,

Saito,

Ito

et al. 2024

BMC Res Notes

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Objectives Thoracoscopy under local anaesthesia is widely performed to diagnose malignancies and infectious diseases. However, few reports have described the use of this procedure for diagnosing and treating intrathoracic infections. This study aimed to evaluate the safety and efficacy of thoracoscopy under local anaesthesia for the management of intrathoracic infections. Results Data from patients who underwent thoracoscopy procedures performed by chest physicians under local anaesthesia at our hospital between January 2018 and December 2023 were retrospectively reviewed. We analysed their demographic factors, reasons for the examinations, diseases targeted, examination lengths, anaesthetic methods used, diagnostic and treatment success rates, as well as any adverse events. Thirty patients were included. Of these, 12 (40%) had thoracoscopies to diagnose infections, and 18 (60%) had them to treat pyothorax. In terms of diagnosing pleurisy, the causative microorganism of origin was identified via thoracoscopy in only three of 12 (25.0%) patients. For diagnosing pyothorax, the causative microorganism was identified in 7 of 18 (38.9%) patients. Methicillin-resistant Staphylococcus aureus was the most common causative microorganism identified. The treatment success rates were very high, ranging between 94.4 and 100%, whereas the identification rate of the causative microorganisms behind infections was low, ranging between 25.0 and 38.9%. The most frequent adverse events included perioperative hypoxaemia and pain. There were two (6.7%) serious adverse events of grade ≥ 3, but none resulted in death. Conclusions The efficacy of managing intrathoracic infections through thoracoscopy under local anaesthesia is commendable. Nonetheless, the diagnostic accuracy of the procedure, regarding the precise identification of the causative microorganisms responsible for intrathoracic infections, persists at a notably low level, presenting a substantial clinical hurdle.

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Local Anaesthetic Thoracoscopy for Pleural Effusion—A Narrative Review

Cited by 6 publications

References 56 publications

Use of medical thoracoscopy in managing pleural malignancy

Use of medical thoracoscopy in managing pleural malignancy

Flexi-rigid Pleuroscopy in Diagnostics of Malignancy: A Narrative Literature Review

Single-centre observational study of the safety and efficacy of thoracoscopy under local anaesthesia for the management of thoracic infections

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