Medical thoracoscopy in 2020: essential and future techniques

Pinelli, Valentina; Clive, Amelia O

doi:10.1183/2312508x.10023519

Cited by 4 publications

(4 citation statements)

References 67 publications

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“…It provides access to the pleural space allowing direct visualisation of the visceral and parietal pleurae. According to the approach, the procedure can be carried out in spontaneously breathing patients (medical thoracoscopy) or under general anaesthesia (thoracoscopic surgery) and can be achieved via one, two or three ports according to the complexity of the intervention intended [89].…”

Section: Endoscopymentioning

confidence: 99%

Imaging of pleural disease

Hassan,

Touman,

Grabczak

et al. 2024

Breathe

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The pleural space is a “potential” anatomical space which is formed of two layers: visceral and parietal. It normally contains a trace of fluid (∼10 mL in each hemithorax). Diseases of the pleura can manifest with thickening of the pleural membranes or by abnormal accumulation of air or liquid. Chest radiographs are often the first imaging tests to point to a pleural pathology. With the exception of pneumothorax, and due to the inherent limitations of chest radiographs, ultrasound and/or computed tomography are usually required to further characterise the pleural pathology and guide management. This review summarises the utility of different imaging tools in the management of pleural disease and discusses new and evolving tools in imaging of the pleura.

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Section: Endoscopymentioning

confidence: 99%

Imaging of pleural disease

Hassan,

Touman,

Grabczak

et al. 2024

Breathe

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“…Inspection of the diaphragm could also potentially identify any defects. There are also case reports of pleurovenous shunts, where the central venous circulation (normally the subclavian vein) is cannulated, but such shunts have high complication rates and have been superseded by the advent of IPCs [16]. A videoassisted thoracoscopic surgical procedure would have required him to be transferred to a tertiary centre and have the appropriate assessment for a general anaesthetic.…”

Section: Answermentioning

confidence: 99%

“…There were concerns about his fitness and the risks associated with such an anaesthetic. There would also be a considerable delay to this and the evidence for this is summarised in the recent ERS Monograph on pleural disease [16].…”

Section: Answermentioning

confidence: 99%

A difficult pleural effusion in a cirrhotic patient

Jackson

Johnston

Mackay

et al. 2020

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“…Medical thoracoscopy (MT) has an important role in the diagnostic pathways of exudative pleural effusions with a diagnostic sensitivity of more than 90% [1]. It can act as a means of conducting pleurodesis thus combining diagnostic and therapeutic roles [2].…”

Section: Introductionmentioning

confidence: 99%

Intracavitary anaesthesia for medical thoracoscopy procedural pain: the CAMP randomised trial

et al. 2021

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Background Medical thoracoscopy (MT) under conscious sedation can be a painful procedure. A pilot study reported reduction in procedural pain with lidocaine application via chest tube before procedure. This study aimed at assessing the extent of effect of intrapleural lidocaine on pain during MT in a double-blind randomised trial. Results Thirty patients (mean age 48.3 years) were recruited, 14 randomised to the lidocaine group and 16 to the saline group. In four patients (two from each group), chest tube insertion prior to MT failed, and they were excluded from the final analysis. The mean (SD) visual analogue scale (VAS) pain score during procedure was 49 ± 33.2 for the lidocaine group and 57.4 ± 27.6 for the control group (mean difference − 8.4 points, p = 0.49). The VAS pain score as assessed by operator was 45.6 ± 19.8 for the lidocaine group and 46.6 ± 29.8 for the control group (p = 0.97). There was no difference in the VAS pain score at 120 min post MT or in the doses of sedatives used during procedure between the study groups. Conclusion ICA for MT does not seem to improve procedural pain as suggested by previous studies. Trial registration The study has been registered with the Pan African Clinical Trial Registry (PACTR202008762D159889).

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Medical thoracoscopy in 2020: essential and future techniques

Cited by 4 publications

References 67 publications

Imaging of pleural disease

Imaging of pleural disease

A difficult pleural effusion in a cirrhotic patient

Intracavitary anaesthesia for medical thoracoscopy procedural pain: the CAMP randomised trial

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