Six years experience of medical thoracoscopy at Al Hussein University Hospital

Halima, Khaled M.I.; Makled, Sameh F; Ali, Safwat M.; Wahba, Ahmed H.; Kabil, Ahmed

doi:10.1016/j.ejcdt.2016.12.002

Cited by 3 publications

(4 citation statements)

References 18 publications

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“…Regarding the safety of rigid thoracoscopy, our study showed good results, as there were no major complications in any patients. Only minor complications like subcutaneous emphysema and air leaks were seen in four patients; such minor complications have also been commonly seen in previous studies 10, 12,13 .…”

Section: Discussionsupporting

confidence: 82%

Role of Single Port Rigid Thoracoscopy in Undiagnosed Pleural Effusion

Rawat,

Kumar,

Mrigpuri

et al. 2024

Tuberc Respir Dis

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Background: In recent years, medical thoracoscopy has been well established to play an important role in undiagnosed pleural effusion; however, this procedure is underutilized due to limited availability of the instruments it requires. This study analysed the outcome of single port rigid thoracoscopy in patients with undiagnosed pleural effusions.Methods: This study retrospectively analysed the outcomes of all patients with undiagnosed pleural effusion presenting to our centre between 2016 to 2020 who underwent single port rigid medical thoracoscopy as a diagnostic procedure.Results: In total, 92 patients underwent single port rigid medical thoracoscopy. The most common presenting symptom was shortness of breath. A majority of the patients had lymphocytic exudative pleural effusion. The average biopsy sample size was 18 mm, and no major complication was reported in any of the patients.Conclusion: Single port rigid thoracoscopy is a safe and well-tolerated procedure that yields a biopsy of a larger size with high diagnostic yield. Moreover, the low cost of the instruments required by this procedure makes it particularly suited for use in developing countries.

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Section: Discussionsupporting

confidence: 82%

Role of Single Port Rigid Thoracoscopy in Undiagnosed Pleural Effusion

Rawat,

Kumar,

Mrigpuri

et al. 2024

Tuberc Respir Dis

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“…Wu Yb et al's [ 4 ] study found malignancy in only 41.1%; this could be explained by the difference in sample size. In Egypt, many previous studies found that the most common diagnosis was malignancy, as Mohamed and Shaban [ 13 ] found malignancy in 87/117 (74.4%) patients, Ahmed et al [ 14 ] found malignancy in 46 (92%) patients, and Halima et al's [ 20 ] study reported malignancies in 83.53% of patients. Adenocarcinoma of the lung was the most common type of malignancy, causing pleural effusion that was observed in (20/47) 42.5% of patients.…”

Section: Discussionmentioning

confidence: 99%

“…This is in agreement with previous studies [ 9 , 21 ]. Malignant pleural mesothelioma (MPM) was diagnosed in (10/47) 21.3 % of patients, while other studies from Egypt such as the one by Mohamed and Shaban [ 13 ] revealed MPM in 47.01% of patients, Halima et al, [ 20 ] revealed MPM in 49.41% of patients, and Helala et al [ 22 ] revealed MPM in 53.6%. This may be explained by the fact that most of the patients in the three previous studies were working or living in neighborhoods with asbestos factories.…”

Section: Discussionmentioning

confidence: 99%

Validity of Pleuroscopy in Evaluating Pleural Effusions of Uncertain Etiology at the Cardiothoracic Unit of Minia University Hospital, Egypt

Abdelaziz,

Hassan,

Abdelfattah

et al. 2024

Cureus

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Introduction: Pleural effusion is a medical condition where an excessive amount of fluid accumulates in the pleural space. This can be caused by inflammation or malignant growth in the body. Doctors use medical thoracoscopy for both diagnostic and therapeutic purposes. This technique allows them to view the internal pleural surfaces and take biopsies of any abnormal lesions within the pleural cavity. Objective: This work aimed to evaluate the diagnostic value of pleuroscopy in patients with undiagnosed exudative pleural effusion. Patients and methods: A study was conducted on 61 patients who had undiagnosed exudative pleural effusion and were admitted to the chest department at the cardiothoracic unit of the Minia University Hospital. All patients provided written consent and underwent a complete history and clinical examination. Standard laboratory tests, including routine liver and kidney function tests, a complete blood count, and a coagulation profile, were conducted on all patients, along with chest X-rays. If necessary, a chest CT scan was also performed. Diagnostic thoracentesis was done, and the pleural fluid was analyzed for sugar, protein, and lactate dehydrogenase and sent for bacteriological analysis (Gram stain, culture, and acid-fast bacilli smear) and cytopathological examination. Medical thoracoscopy was performed in cases where an etiological diagnosis was not established. Results: A total of 61 patients with undiagnosed exudative pleural effusions were included. A definitive etiological diagnosis was reached in 58 (95%) patients. In 47 (77%) of the studied group, malignant etiology was confirmed; nine (14.8%) had tuberculous pleurisy, one (1.6%) had empyema, and one (1.6%) had inflammatory/autoimmune pleurisy. A definite diagnosis was not reached in three (5%) patients. The malignant pathology was caused by bronchogenic carcinoma in 20 (42.5%) cases, malignant mesothelioma in 10 (21.3%) cases, metastatic malignant deposits from other organs in six (12.7%) cases, and lymphoma in three (6.5%) cases. No serious adverse events related to the procedure were recorded. The most common minor complications were transient chest pain in 34 (55.7%) patients, followed by surgical emphysema in 10 (16.4%) patients. Conclusion: Pleuroscopy is an effective diagnostic tool for identifying the cause of pleural effusion when it is unclear. It is a minimally invasive and straightforward procedure associated with high diagnostic accuracy and low complication rates.

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“…In PubMed or Google search, no article has been found particularly on the diagnosis of thymic tumors using medical thoracoscopy. Instead, small number of thymic tumors diagnosed by this method can be found in the mostly retrospective studies on diagnosis and treatment of mediastinal tumors by thoracoscopy (59) or on medical thoracoscopy in the management of undiagnosed pleural effusions (60). Over the last two decades, besides other minimally invasive procedures such as EBUS-TBNA, EUS-FNA and mediastinoscopy, the upward trend in the use of medical thoracoscopy for the pretreatment diagnosis of locally advanced thymic tumors is noteworthy (6).…”

Section: Medical Thoracoscopymentioning

confidence: 99%

How to obtain adequate biopsy specımen in suspected thymic tumors

Bilaçeroğlu¹

2020

J Thorac Dis

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Pathologic diagnosis of thymic tumors (TTs) can be made by surgical or nonsurgical procedures. About 20% of TTs had been diagnosed by pretreatment biopsy methods while the rest had gone to surgery for diagnosis and treatment. However, in the last two decades there was an increase in pretreatment procedures for optimal management of locally advanced or metastatic TTs. Pretreatment tissue diagnosis of a noninvasive TT is not a standard option but is required if there is suspect or atypical clinical presentation and imaging, an invasive tumor requiring a nonsurgical approach or preoperative chemotherapy or chemoradiotherapy, strong possibility of lymphoma or unclear differential diagnosis between lymphoma or other solid tumor by imaging studies, or suspicion of a metastatic lesion. In surgical diagnosis anterior mediastinotomy, video-assisted thoracic surgery or mediastinoscopy can be chosen for invasive TTs whereas total resection is performed for small, noninvasive tumors. Nonsurgical diagnosis can be made by transthoracic fine or core needle biopsies (TTFNA, TTCNB), conventional bronchoscopy, endobronchial ultrasonography-guided transbronchial needle aspiration (EBUS-TBNA), endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) or medical thoracoscopy depending on procedural amenability according to tumor extension. TTFNA and TTCNB have been the most frequently used nonsurgical methods. However, there is an upward trend in using conventional bronchoscopy, EBUS-TBNA, EUS-FNA and medical thoracoscopy recently. To increase the diagnostic performance of these procedures in TTs, recommendations are (I) obtaining histologic specimens, (II) combining smears or liquid based cytology preparations and cell blocks, (III) obtaining multiple sufficient samples, (IV) combining histologic and cytologic specimens, (V) performing morphologic, immunohistochemical and molecular analyses on all specimens, (VI) using rapid onsite evaluation for cytologic specimens, (VII) correlating pathologic, clinical and radiologic findings, (VIII) consulting experienced pathologists.

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Six years experience of medical thoracoscopy at Al Hussein University Hospital

Cited by 3 publications

References 18 publications

Role of Single Port Rigid Thoracoscopy in Undiagnosed Pleural Effusion

Role of Single Port Rigid Thoracoscopy in Undiagnosed Pleural Effusion

Validity of Pleuroscopy in Evaluating Pleural Effusions of Uncertain Etiology at the Cardiothoracic Unit of Minia University Hospital, Egypt

How to obtain adequate biopsy specımen in suspected thymic tumors

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