Ultrasound-Guided Medical Thoracoscopy in the Absence of Pleural Effusion

Marchetti, Giampietro; Valsecchi, Alberto; Indellicati, Davide; Arondi, Sabrina; Trigiani, Marco; Pinelli, Valentina

doi:10.1378/chest.14-0637

Cited by 70 publications

(52 citation statements)

References 13 publications

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“…In fact, if there is no diffuse adherence between the visceral pleura and parietal pleura, this space can be entered with MT even though pleural fluid does not exist. In a recently conducted study involving MT including a series of 622 patients, it was reported that MT was successfully and safely performed in 29 patients not having pleural fluid, but having a sliding sign (overlapping pleura) on ultrasonography (11). This series will be an important initiative with regard to MT studies.…”

Section: Current Practical Medical Thoracoscopy Applicationsmentioning

confidence: 94%

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Medical thoracoscopy at 105. Anniversary

Metintaş¹

2015

Eurasian J Pulmonol

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Medical thoracoscopy (MT) for cases of exudative pleural effusion without a diagnosis by either clinical, radiological, laboratory or cytological investigation is performed as an established diagnostic method for the diagnosis of pleural diseases which has been performed routinely in many clinics. MT was done mainly with a rigid thoracoscope under mild sedation and local anesthesia in an endoscopy room with basic monitoring. It allows for the direct inspection of the pleural space and biopsies taken under direct vision. The diagnostic yield is in the order of 90-95% for malignant disease and can be as high as 100% for pleural tuberculosis. Additionally, MT can be performed for therapeutic as well as diagnostic purposes. Although MT remains an invasive procedure, complications are infrequently seen. Due to both the advantages of MT and the gradually increasing incidence of mesothelioma and malignant pleural disease, the use of MT for pleural effusions will be increasing in pulmonary clinics in coming years. Additionally MT will have some new developments; such as semirigid thoracoscopy, florescent or auto-florescent thoracoscopy, narrow-band imaging, thoracoscopy in patients without pleural effusion.

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Section: Current Practical Medical Thoracoscopy Applicationsmentioning

confidence: 94%

“…In the United Kingdom, although MT was used in 11 health centers in 1999, the number of centers where it was used increased to 17 in 2004 and to 37 in 2009 (3). Its usage in USA is becoming widespread gradually, and its use in outpatients and in patients without fluid has recently been recommended (10,11).…”

Section: Medical Thoracoscopy For Diagnostic Purposementioning

confidence: 99%

Medical thoracoscopy at 105. Anniversary

Metintaş¹

2015

Eurasian J Pulmonol

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“…When present, this sign shows the absence of adhesions and the possibility of a pneumothorax to be induced and the thoracoscopy to be performed, even in the complete absence of pleural effusion. In these cases an iatrogenic pneumothorax can be created using the Boutin needle (19), or with the direct careful insertion of the trocar (20).…”

Section: Medical Thoracoscopymentioning

confidence: 99%

Endoscopic diagnosis and management of pleural effusion in malignant pleural mesothelioma

et al. 2018

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“…Gaining access to the thoracic cavity is relatively straightforward in the context of a moderate to large pleural effusion; however, the absence of any pleural fluid should not be considered a barrier to medical thoracoscopy. Assuming significant pleural adhesions are excluded through the confirmation of lung sliding on ultrasound, pneumothorax induction can then be safely performed using either blunt dissection or Boutin needle introduction under real-time ultrasound visualisation [115,116]. Following a complete inspection of the thoracic cavity, biopsies of the parietal pleura are then obtained; the authors would advise taking multiple biopsies from different sites to maximise the probability of a secure diagnosis.…”

Section: Technical Considerationsmentioning

confidence: 99%

Advanced medical interventions in pleural disease

et al. 2016

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The burden of a number of pleural diseases continues to increase internationally. Although many pleural procedures have historically been the domain of interventional radiologists or thoracic surgeons, in recent years, there has been a marked expansion in the techniques available to the pulmonologist. This has been due in part to both technological advancements and a greater recognition that pleural disease is an important subspecialty of respiratory medicine. This article summarises the important literature relating to a number of advanced pleural interventions, including medical thoracoscopy, the insertion and use of indwelling pleural catheters, pleural manometry, point-of-care thoracic ultrasound, and image-guided closed pleural biopsy. We also aim to inform the reader regarding the latest updates to more established procedures such as chemical pleurodesis, thoracentesis and the management of chest drains, drawing on contemporary data from recent randomised trials. Finally, we shall look to explore the challenges faced by those practicing pleural medicine, especially relating to training, as well as possible future directions for the use and expansion of advanced medical interventions in pleural disease. @ERSpublications Technological advances and greater availability of techniques give a broad range of interventions for pleural disease http://ow.ly/ZNya2

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Ultrasound-Guided Medical Thoracoscopy in the Absence of Pleural Effusion

Cited by 70 publications

References 13 publications

Medical thoracoscopy at 105. Anniversary

Medical thoracoscopy at 105. Anniversary

Endoscopic diagnosis and management of pleural effusion in malignant pleural mesothelioma

Advanced medical interventions in pleural disease

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