Thoracic ultrasound versus artificial pneumothorax in complications of medical thoracoscopy—a propensity score matching analysis

Huang, Junjun; Hu, Yan; Mu, Xiaojing; Liao, Jiping; Wang, Xi; Zhang, Hong; Wang, Guangfa

doi:10.21037/jtd.2018.08.41

Cited by 5 publications

(5 citation statements)

References 22 publications

(20 reference statements)

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“…They reported a very low risk of complications. More recently, Huang et al compared the two techniques for establishing the point of entry (artificial pneumothorax vs. TU), using a propensity score matching analysis (31). No significant differences in major and minor complications were noted between the two groups.…”

Section: Point Of Entrymentioning

confidence: 99%

Pleuroscopy or video-assisted thoracoscopic surgery for exudative pleural effusion: a comparative overview

Ali¹,

Light²,

Maldonado³

2019

J. Thorac. Dis

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Exudative pleural effusions, such as malignant and tuberculous pleural effusions, are associated with notable morbidity and mortality. Unfortunately, a significant number of these effusions will remain undiagnosed despite thoracentesis. Traditionally, closed pleural biopsies have been the next best diagnostic step, but the diagnostic yield of blind closed pleural biopsies for malignant pleural effusions is insufficient.When image-guided targeted biopsies are not possible, both pleuroscopy and video-assisted thoracoscopic surgery are reasonable options for obtaining pleural biopsies, but the decision to select one procedure over the other continues to raise much debate. Pleuroscopy (aka. medical thoracoscopy, local anaesthetic thoracoscopy) is a relatively common procedure performed by interventional pulmonologists in the bronchoscopy suite with local anesthesia, often as an outpatient procedure, on spontaneously breathing patients. Video-assisted thoracoscopic surgery, on the other hand, is performed by thoracic surgeons in the operating room, on mechanically ventilated patients under general anesthesia, though admittedly considerable overlap exists in practice. Both pleuroscopy and video-assisted thoracoscopic surgery have reported diagnostic yields of over 90%, although pleuroscopy more often leads to the unsatisfactory diagnosis of 'non-specific' pleuritis. These cases of 'non-specific' pleuritis need to be followed up for at least one year, as 10-15% of them will eventually lead to the diagnosis of cancer, typically malignant pleural mesothelioma. Both procedures have their pros and cons, and it is therefore of paramount importance that all cases be discussed as part of a multidisciplinary approach to diagnosis within a "pleural team" that should ideally include interventional pulmonologists and thoracic surgeons.

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Section: Point Of Entrymentioning

confidence: 99%

Pleuroscopy or video-assisted thoracoscopic surgery for exudative pleural effusion: a comparative overview

Ali¹,

Light²,

Maldonado³

2019

J. Thorac. Dis

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“…[ 17 ] In another study, ultrasonography was considered an alternative to aspiration in determining the nature of pleural effusion, especially in older individuals. [ 18 – 20 ] In their results, anechoic effusion was observed in 100% transudates and 14% exudates. However, another study published in the previous year examined the TUS findings of 300 consecutive pleural effusions and found that an anechoic appearance was associated with 56% of exudative effusions compared to 44% of transudative effusions.…”

Section: Discussionmentioning

confidence: 99%

Value of ultrasonography in determining the nature of pleural effusion: Analysis of 582 cases

Wang¹,

Fang³

et al. 2022

Medicine

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To explore the value of ultrasonography in the auxiliary diagnosis of pleural effusion, we retrospectively analyzed the ultrasonographic findings of 275 exudates and 307 transudates and summarized the ultrasonographic image features of pleural effusion according to patients’ primary diseases. The findings of thoracic ultrasonography performed before the initial thoracentesis in 582 patients with subsequently confirmed exudative/transudative pleural effusion were analyzed with regard to the sonographic features of pleural effusion. In 275 cases with exudates, thoracic ultrasonography showed a complex septate appearance in 19 cases (6.9%), complex nonseptate appearance in 100 cases (36.4%), complex homogenous sign in 46 cases (16.7%), and pleural thickness > 3 mm in 105 cases. In contrast, in 307 patients with transudates, most patients (97.1%) had bilateral pleural effusion. Ultrasonographic images displayed anechoic appearance and absence of pleural thickening in a vast majority of cases (306, 99.7%; 301, 98%). These positive findings in the exudate were statistically higher than those in their counterparts (P < .05). In the empyema subgroup, the proportion of complex septate appearance, complex nonseptate appearance, complex homogenous sign, and pleural thickening was the highest, at 19/41, 12/41, 10/41, and 30/41, respectively. Ultrasonography is valuable in defining the nature of pleural effusion. Some sonographic features of pleural effusion, such as echogenicity, septation, and pleural thickening, may indicate a high risk of exudative pleural effusion.

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“…This is because the air in the pleura covers the effusion during respiration (Figure 8). 20,[31][32][33] Figure 8. Pneumothorax and hydropneumothorax.…”

Section: Pneumothorax and Hydropneumothoraxmentioning

confidence: 99%

Thoracic Ultrasound: A Narrative Literature Review

Atikanur,

Indi Esha

2023

Bioscmed

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Ultrasonography (USG) is useful in diagnosing abnormalities in the thoracic area, such as pleural effusion, pneumothorax, consolidation, atelectasis, pulmonary edema, etc. The advantages of thoracic ultrasound are low cost, non-radiation, non-invasive, easy to carry, short examination time, and a dynamic aspect that can be seen during the examination. Thoracic ultrasound can be used to guide thoracentesis procedures, chest tube placement, and aspiration of lung abscesses. Ultrasound can be substituted as a computed tomography scan (CT-Scan) as a guide for aspiration and biopsy of the lung parenchyma, pleura, and chest wall. Portable and compact ultrasonography provides the opportunity for ultrasound examinations to become a routine part of an examination, like a stethoscope. Ultrasonography also has limitations in patients with subcutaneous emphysema, peripheral edema, and obesity. Ultrasound examination is very dependent on the experience and abilities of the operator.

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Thoracic ultrasound versus artificial pneumothorax in complications of medical thoracoscopy—a propensity score matching analysis

Cited by 5 publications

References 22 publications

Pleuroscopy or video-assisted thoracoscopic surgery for exudative pleural effusion: a comparative overview

Pleuroscopy or video-assisted thoracoscopic surgery for exudative pleural effusion: a comparative overview

Value of ultrasonography in determining the nature of pleural effusion: Analysis of 582 cases

Thoracic Ultrasound: A Narrative Literature Review

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