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Medical thoracoscopy

Sachin S Dole, Gauri P Godbole, Himanshu S Pophale
BACKGROUND: Medical thoracoscopy has received interest in recent past for diagnostic as well as therapeutic uses. In this study we describe our experience with diagnostic medical thoracoscopy in pleural effusions of undiagnosed etiology. OBJECTIVE: 1.To detect diagnostic yield of medical thoracoscopy in pleural effusions of unknown etiology. 2.To find complication rate in these patients. METHODOLOGY: In a retrospective analysis of thoracoscopic procedures performed between March 2011 and December 2014, diagnostic yield and complications of thoracoscopic pleural biopsy for achieving a diagnosis in undiagnosed pleural effusions were evaluated...
October 2016: Journal of the Association of Physicians of India
Sarah Townsend, Michelle L Oblak, Ameet Singh, Michele A Steffey, Jeffrey J Runge
OBJECTIVE: To report the diagnosis, treatment, and short-term outcome in dogs with suspected persistent right aortic arch (PRAA) undergoing thoracoscopy with concurrent esophagoscopy. STUDY DESIGN: Multi-institutional retrospective case series. ANIMALS: Dogs with suspected PRAA (n=9). METHODS: Medical records were reviewed from 2012 to 2016. Dogs undergoing thoracoscopy for PRAA at 3 referral hospitals were included...
October 12, 2016: Veterinary Surgery: VS
Chetan Basavaraj Patil, Ramakant Dixit, Rakesh Gupta, Neeraj Gupta, Varna Indushekar
BACKGROUND: Medical thoracoscopy is a minimally invasive procedure used in diagnostic and therapeutic applications for pleural diseases. In this study, we describe our experience in the outcome and analysis of thoracoscopy in undiagnosed pleural effusion presenting to our center. MATERIALS AND METHODS: This is a prospective study conducted over last 2 years. We performed thoracoscopy in 129 cases of undiagnosed exudative pleural effusions using rigid thoracoscope...
September 2016: Lung India: Official Organ of Indian Chest Society
William S Ragalie, Paula M Termuhlen, Alex G Little
BACKGROUND: Although exposure to thoracic surgery is mandated in general surgery residency, little is known about the mix of cases that residents use to meet this requirement and how this has changed over time. We report the experience of general thoracic surgery among general surgery residents using the Accreditation Council for Graduate Medical Education (ACGME) database. METHODS: We performed a retrospective review of the prospectively maintained ACGME resident case log database from 2003 to 2013...
September 9, 2016: Annals of Thoracic Surgery
Alberto Valsecchi, Sabrina Arondi, Giampietro Marchetti
BACKGROUND: Medical thoracoscopy (MT) or pleuroscopy is a procedure performed to diagnose and treat malignant and benign pleural diseases. Totally 2752 pleuroscopies executed in 1984-2013 in our center were considered in this study. METHODS: A retrospective observational study was performed. Observational time was divided into six series of 5 years. We calculated MT diagnostic yield and analyzed trends of main diseases diagnosed along the time. RESULTS: Along the 30 years population became progressively older...
July 2016: Annals of Thoracic Medicine
Kipyo Hong, Mikyung Bae, Sora Han
BACKGROUND: The purpose of this study was to evaluate the efficacy of our subcostal closure technique in prevention of postthoracotomy pain syndrome. METHODS: From July 2012 to March 2015, 29 patients in whom a lobectomy was indicated underwent a thoracotomy. The thoracotomy wounds were closed using a subcostal closure technique (subcostal closure group) and outcomes were compared with 31 patients who underwent video-assisted thoracoscopic surgery (thoracoscopy group)...
September 2016: Asian Cardiovascular & Thoracic Annals
Shimaa Nour Moursi Ahmed, Hideo Saka, Hamdy Ali Mohammadien, Ola Alkady, Masahide Oki, Yoshimasa Tanikawa, Rie Tsuboi, Masahiro Aoyama, Keiji Sugiyama
Objectives. To highlight the possible complications of medical thoracoscopy (MT) and how to avoid them. Methods. A retrospective and prospective analysis of 127 patients undergoing MT in Nagoya Medical Center (NMC) and Toyota Kosei Hospital. The data about complications was obtained from the patients, notes on the computer system, and radiographs. Results. The median age was 71.0 (range, 33.0-92.0) years and 101 (79.5%) were males. The median time with chest drain after procedure was 7.0 (range, 0.0-47.0) days and cases with talc poudrage were 30 (23...
2016: Advances in Medicine
Tarek Dammad, Joshua Duchesne, Susan Pasnick
Solitary fibrous tumor of the pleura (SFTP) is a rare tumor of fibroblastic origin. It can be quite vascular, and its surgical management carries the risk of a major intra-operative bleed. The pre-operative use of endobronchial ultrasound (EBUS) to visualize the vascular supply of the tumor has not been reported.We report a case of a patient presenting with progressive shortness of breath and cough who was found to have a very large pleural-based tumor. We describe the use of medical thoracoscopy and EBUS to establish the diagnosis of SFTP and to characterize the blood supply of the tumor...
July 2016: Medicine (Baltimore)
H Wurps, N Schönfeld, T T Bauer, M Bock, C Duve, R Sauer, T Mairinger, S Griff
BACKGROUND: There is only few data available on the use of cryotechnique during medical thoracoscopy. METHODS: Medical thoracoscopy was performed in consecutive patients with pleural effusion. Prospectively, biopsies were taken by rigid forceps, flexible forceps and cryoprobe. Specimen size, depth and diagnostic yield were compared. RESULTS: 80 Patients were included. 408 biopsies were taken (205 rigid biopsies, 104 flexible biopsies, 99 cryobiopsies)...
2016: BMC Pulmonary Medicine
Kostas Archontogeorgis, Anthony Lanfranco, Andreas Koulelidis, Marios E Froudarakis
Bilateral empyema associated to infectious pericarditis is an extremely rare, yet life-threatening condition. Pleuroscopy-medical thoracoscopy has proved its efficacy in series of patients with empyema. Yet, all reported cases treated by this technique, concerned patients with pleural infection located to a single hemithorax. We present the case of a 71-year-old man with bilateral empyema treated successfully by sequential pleuroscopy, associated to infectious pericarditis.
2016: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
Ramesh L Narasimhan, Inderpaul S Sehgal, Sahajal Dhooria, Ashutosh N Aggarwal, Digambar Behera, Ritesh Agarwal
Intrapleural foreign body is an uncommon condition, usually encountered in the setting of thoracic trauma, but can rarely complicate diagnostic procedures such as thoracentesis. The management involves urgent identification and removal of the foreign body. Although surgical extraction using thoracotomy or video-assisted thoracoscopic surgery under general anesthesia constitutes the primary management strategy, intrapleural foreign body can also be removed using medical thoracoscopy. Herein, we report the successful removal of 2 intrapleural foreign bodies using a rigid thoracoscope under local anesthesia and conscious sedation...
June 30, 2016: Journal of Bronchology & Interventional Pulmonology
Rahul Bhatnagar, John P Corcoran, Fabien Maldonado, David Feller-Kopman, Julius Janssen, Philippe Astoul, Najib M Rahman
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...
June 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
Diego Gonzalez-Rivas
The development of thoracoscopy has more than one hundred years of history since Jacobaeus described the first procedure in 1910. He used the thoracoscope to lyse adhesions in tuberculosis patients. This technique was adopted throughout Europe in the early decades of the 20(th) century for minor and diagnostic procedures. It is only in the last two decades that interest in minimally invasive thoracic surgery was reintroduced by two key technological improvements: the development of better thoracoscopic cameras and the availability of endoscopic linear mechanical staplers...
March 2016: Annals of Cardiothoracic Surgery
Jacopo Vannucci, Andrea Droghetti, Antonello Bufalari, Valentina De Monte, Guido Bellezza, Fortunato Bianconi, Roberta Pecoriello, Niccolò Daddi, Franco Moriconi, Francesco Puma
OBJECTIVES: The human fibrinogen/thrombin surgical patch is proposed for videothoracoscopic pleurodesis after recurrent observation in routine clinical practice of site-specific pleuro-pulmonary adhesions. METHODS: A total of 36 experimental videothoracoscopies were performed on 18 pigs, all of which underwent a bilateral sequential procedure. The right or left side was casually approached and two 4.8 × 4.8 cm Tachosil® patches were placed over the dorsal lung surface in the highest antigravitary position through a double-port thoracoscopy...
April 22, 2016: European Journal of Cardio-thoracic Surgery
Ilias Porfyridis, Georgios Georgiadis, Michalis Michael, Frangiskos Frangopoulos, Paris Vogazianos, Alexis Papadopoulos, Panayiota Kara, Charis Charalampous, Andreas Georgiou
BACKGROUND AND OBJECTIVE: Medical thoracoscopy (MT) is useful for the management of pleural disease. Rapid on-site evaluation (ROSE) of transbronchial needle aspirates proved to be useful during bronchoscopy. We aimed to evaluate the diagnostic performance of ROSE of MT biopsy specimens and thoracoscopists' impression of the macroscopic appearance and assess the intermodality agreement between ROSE and final histopathologic diagnosis. METHODS: Sixty two patients with exudative pleural effusions further investigated with MT were enrolled...
August 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
Anna C Bibby, Nick A Maskell
PURPOSE OF REVIEW: Pleural biopsies are often necessary if a pleural effusion remains undiagnosed after radiological imaging and pleural fluid analysis. There are many methods of obtaining pleural biopsies, including blind or image-guided procedures, closed-bevel or cutting-edge needles, and percutaneous or thoracoscopic approaches. This article will review recent research relating to these methods, aiming to provide an overview of the strengths and limitations of each technique. RECENT FINDINGS: Historically pleural biopsies were undertaken using a blind closed 'Abrams' needle method...
July 2016: Current Opinion in Pulmonary Medicine
Pyng Lee, Praveen N Mathur
PURPOSE OF REVIEW: Medical thoracoscopy provides the physician a window into the pleural space. The procedure allows biopsy of the parietal pleura under direct visualization with good accuracy. In addition, it achieves therapeutic goals of fluid drainage, guided chest tube placement, and pleurodesis. RECENT FINDINGS: Comparable diagnostic yield is achieved with the flexi-rigid pleuroscope even though pleural biopsies are smaller using the flexible forceps as compared to rigid thoracoscopy...
May 2016: Current Opinion in Pulmonary Medicine
Tariq Altokhais, Mohammad Aqil Soomro, Abdulmonem Gado, Abdulrahman Albassam
Objectives This study aims to evaluate the feasibility, safety, limitations, and outcomes of performing different surgical approaches and techniques for the bedside repair of congenital diaphragmatic hernia (CDH) in critically ill patients who cannot be transferred to the operating room. Study Design Between December 1997 and July 2013, medical charts of all neonates operated on at the bedside for CDH while on high-frequency oscillatory ventilation (HFOV) and nitric oxide were reviewed. Demographic data; contributing antenatal, perinatal, and postnatal factors; clinical presentation; associated anomalies; respiratory and hemodynamic status; operative details; complications, and outcome were analyzed...
July 2016: American Journal of Perinatology
Yu Xiong, Xusheng Gao, Huaiyang Zhu, Caihong Ding, Jian Wang
BACKGROUND: Fibrous tuberculous pleural effusion (TPE) represents common disease in tuberculous clinic. Medical thoracoscopy has been used to treat pleural empyema and shown promising outcomes, but data of its use in multiloculated and organized TPE remains limited to know. METHODS: The study was performed on 430 cases with TPE. The cases were divided into free-flowing, multiloculated effusion and organized effusion group. Each group was subdivided into two or three types of therapeutic approaches: ultrasound guided pigtail catheter, large-bore tube chest drainage and medical thoracoscopy...
January 2016: Journal of Thoracic Disease
So Hyun Nam, Min Jeong Cho, Dae Yeon Kim
PURPOSE: The aim of this study is to present our experience with minimally invasive surgery (MIS) for congenital cystic adenomatoid malformations (CCAMs). METHODS: The medical records of infants under 2 years of age who underwent operation for a CCAM from 2009 to 2014 were retrospectively reviewed. RESULTS: MIS (9 of thoracoscopy and 1 of laparoscopy) was performed for 10 infants (male:female = 7:3) with CCAM. CCAM were discovered prenatally around gestational age of 24...
February 2016: Annals of Surgical Treatment and Research
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