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Medical thoracoscopy

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https://www.readbyqxmd.com/read/29679518/new-insights-in-the-use-of-pleural-ultrasonography-for-diagnosis-and-treatment-of-pleural-disease
#1
Giampietro Marchetti, Sabrina Arondi, Francesca Baglivo, Sara Lonni, Federico Quadri, Alberto Valsecchi, Nicola Venturoli, Paolo Ceruti
The use of transthoracic ultrasound has acquired a wide consensus among respiratory physicians during the last few years. The developing of portable and easily available devices favorites patient's bedside evaluation. Transthoracic ultrasound provides rapid, real-time and low-cost diagnostic information, allowing image-guided chest interventions and reducing procedural risks. The different acoustic impedance between aerated and not aerated organs produces artifacts known as A lines, B lines, sliding sign, lung point, etc...
April 21, 2018: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29615010/malignant-pleural-mesothelioma-diagnostic-value-of-medical-thoracoscopy-and-long-term-prognostic-analysis
#2
Li-Li Xu, Yuan Yang, Zhen Wang, Xiao-Juan Wang, Zhao-Hui Tong, Huan-Zhong Shi
BACKGROUND: Malignant pleural mesothelioma (MPM) is marked by its difficult diagnosis and poor prognosis. Medical thoracoscopy (MT) is an effective and safe procedure for the diagnosis of exudative pleural effusions and many factors associated with poor prognosis of MPM. We conducted this study to investigate the value of MT for diagnosing of MPM and to identify prognostic factors for MPM patients. METHODS: From July 2005 through June 2014, a total of 833 patients with undiagnosed pleural effusions underwent MT and pleural biopsies were taken...
April 3, 2018: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29607149/thoracoscopic-primary-repair-with-mediastinal-drainage-is-a-viable-option-for-patients-with-boerhaave-s-syndrome
#3
Toru Nakano, Ko Onodera, Hirofumi Ichikawa, Takashi Kamei, Yusuke Taniyama, Tadashi Sakurai, Go Miyata
Background: Spontaneous esophageal rupture (Boerhaave's syndrome) is an emergency that can cause life-threatening conditions. Various procedures have been used to treat Boerhaave's syndrome. However, a standard surgical procedure has not been established. Herein, we report our experience with primary suture of the ruptured esophagus via a thoracoscopy or laparotomy. Methods: Between November 2002 and May 2015, 11 patients with Boerhaave's syndrome presented to our department and were managed using one of two surgical procedures based on the surgeon's discretion...
February 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29602484/-blue-rubber-bleb-naevus-syndrome-involving-the-pleura
#4
P H Aussedat, S Laroumagne, H Dutau, P Astoul
Bean's syndrome ('blue rubber bleb nevus syndrome') is a rare disease characterized by venous malformations involving various organs. Most often these lesions are localized to the skin and the digestive system. Gastro-intestinal bleeding is the most frequent presentation. Though other organs can be affected, chest localizations are infrequent and pleural localization is exceptional. We report the case of an asbestos-exposed patient with Bean's syndrome with characteristic skin lesions, smoker, hospitalized for the investigation of a hemorrhagic pleural effusion...
March 28, 2018: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/29531204/drainage-of-multiloculated-tuberculous-pleural-effusion-by-medical-thoracoscopy-when-and-why-should-it-be-considered
#5
S S Kho, S K Chan, M C Yong, S T Tie
Tuberculous pleural effusion (TBE) is a common encounter in our region. Up to 50% of patients with TBE will develop residual pleural thickening (RPT) which can lead to functional impairment. However, the need of drainage remains controversial. We report a case of end-stage renal failure patient who presented with right multiloculated tuberculous pleural effusion which was drained via a medical thoracoscope. Patient reports immediate relief of breathlessness post procedure and one month follow up shown significant improvement of RPT...
February 2018: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/29522809/onset-and-evolution-of-clinically-apparent-myasthenia-gravis-after-resection-of-non-myasthenic-thymomas
#6
Tommaso Claudio Mineo, Alessandro Tamburrini, Orazio Schillaci, Vincenzo Ambrogi
BACKGROUND: Patients with thymoma and without clinical or electromyographical myasthenic signs may occasionally develop myasthenia several years after thymectomy. Hereby, we investigated the predictors and the evolution of this peculiar disease. METHODS: We performed a retrospective analysis in 104 consecutive patients undergoing thymectomy between 1987 and 2013 for thymoma without clinical nor electromyographic signs of myasthenia gravis. Predictors of post-thymectomy onset of myasthenia gravis were investigated with univariale time-to-disease analysis...
March 6, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29507795/endoscopic-diagnosis-and-management-of-pleural-effusion-in-malignant-pleural-mesothelioma
#7
REVIEW
Paolo Ceruti, Sara Lonni, Francesca Baglivo, Giampietro Marchetti
Malignant pleural mesothelioma (MPM) is an asbestos-related aggressive tumor, that requires proper diagnosis and management. Symptoms are nonspecific and chest computed tomography (CT) and chest ultrasound (US) are important radiological tools in the initial workup to identify early pathological signs. Performing a medical thoracoscopy (MT) is essential for a definitive diagnosis of MPM. The procedure, integrated with a prior US, allows a global evaluation of the pleural cavity and the execution of multiple targeted biopsies, with low risk of complications...
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29506211/bronchopulmonary-sequestrations-in-a-paediatric-centre-ongoing-practices-and-debated-management
#8
Naziha Khen-Dunlop, Konstantinos Farmakis, Laureline Berteloot, Francesca Gobbo, Julien Stirnemann, Jacques De Blic, Francis Brunelle, Christophe Delacourt, Yann Revillon
OBJECTIVES: Bronchopulmonary sequestration (BPS) is the second most common congenital lung malformation, with an estimated incidence ranging from 0.15% to 1.8%. Surgical treatment is elective in patients with symptoms, but the management of asymptomatic patients remains controversial. METHODS: We retrospectively reviewed the medical records of 99 patients treated for BPS in our institution from January 2000 to December 2015. BPS was diagnosed prenatally in 86 (87%) cases...
February 28, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29478341/the-role-of-pleurodesis-in-respiratory-diseases
#9
Rachel M Mercer, Maged Hassan, Najib M Rahman
Pleurodesis is used to obliterate the pleural space, most commonly in patients with symptomatic malignant pleural effusions but also in patients with benign effusions or pneumothorax. Areas covered: Traditionally, chemical pleurodesis has been undertaken at thoracoscopy or using instillation of a slurry through a chest drain. The optimum method of achieving pleurodesis, whether surgical or medical, has yet to be proven. Evidence in the different disease areas will be reviewed, along with ongoing trial evidence, which may change practice...
April 2018: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29442240/review-of-emerging-surgical-robotic-technology
#10
REVIEW
Brian S Peters, Priscila R Armijo, Crystal Krause, Songita A Choudhury, Dmitry Oleynikov
BACKGROUND: The use of laparoscopic and robotic procedures has increased in general surgery. Minimally invasive robotic surgery has made tremendous progress in a relatively short period of time, realizing improvements for both the patient and surgeon. This has led to an increase in the use and development of robotic devices and platforms for general surgery. The purpose of this review is to explore current and emerging surgical robotic technologies in a growing and dynamic environment of research and development...
February 13, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29435191/effect-of-postoperative-systemic-therapy-on-pulmonary-adenocarcinoma-with-unexpected-pleural-spread-detected-during-thoracotomy-or-thoracoscopy
#11
Chi-Lu Chiang, Lei-Chi Wang, Hsiang-Ling Ho, Chun-Ming Tsai, Yi-Chen Yeh, Wen-Hu Hsu, Teh-Ying Chou, Chao-Hua Chiu, Yu-Chung Wu
Background: Occasionally, malignant pleural disease is only detected unexpectedly during surgery in patients with pulmonary adenocarcinoma. Previous studies mostly focused on the role of main tumor resection on patient's outcome, barely addressing the position of postoperative systemic therapy. Methods: The medical records of 5321 non-small cell lung cancer patients who underwent thoracic surgery between January 1990 and December 2012 were reviewed. Pulmonary adenocarcinoma patients with unexpected pleural spread noted during surgery were included...
January 12, 2018: Oncotarget
https://www.readbyqxmd.com/read/29429254/-evaluation-of-the-diagnosis-value-of-carcinoembryonic-antigen-in-malignant-pleural-effusion
#12
Y X Yu, Z H Tong, X X Zhou, L R Liang, Z Wang, L L Xu, X J Wang, Y B Wu, H J Li, Z Lu
Objective: To investigate the diagnostic value of serum and pleural fluid carcinoembryonic antigen (CEA) for malignant pleural effusion (MPE). Methods: The concentration of CEA in serum and pleural fluid of 286 patients with the diagnosis confirmed by pleural biopsy through medical thoracoscopy were retrospectively analyzed. MPE was confirmed in 171 cases which were divided into two groups (adenocarcinoma group with 121cases and non-adenocarcinoma group with 50 cases) and benign pleural effusion in 115 cases...
February 6, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29346252/sarcoidosis-with-pleural-effusion-as-the-presenting-symptom
#13
Estefania Rivera, Yaron Gesthalter, Paul Vardelaan, Alex Chee, Adnan Majid
A 65-year-old woman, never smoker, with medical history of hypertension, nonischemic cardiomyopathy, and moderate pulmonary hypertension presented with symptomatic bilateral pleural effusions. Thoracentesis revealed a lymphocyte predominant transudate and was negative for malignancy, microbiologic cultures were negative for an infectious cause. Chest tomography showed mediastinal and bilateral hilar lymphadenopathy, lymph node biopsy with endobronchial ultrasound-guided transbronchial needle aspiration showed non-necrotizing granulomas compatible with sarcoidosis...
April 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29344253/diagnostic-value-of-medical-thoracoscopy-in-malignant-pleural-effusion-induced-by-non-hodgkin-s-lymphoma
#14
Zhen Wang, Yan-Bing Wu, Li-Li Xu, Mu-Lan Jin, Xiao-Li Diao, Xiao-Juan Wang, Zhao-Hui Tong, Huan-Zhong Shi
Malignant pleural effusion (MPE) appears in up to 20% of patients with non-Hodgkin's lymphoma (NHL). The present study aimed to assess the efficacy of medical thoracoscopy (MT) in the diagnosis of patients with MPE induced by NHL. Between July 2005 and June 2014, 833 patients with pleural effusions of unknown etiology underwent MT in Beijing Chaoyang Hospital (Beijing, China), where diagnostic thoracocentesis or/and blind pleural biopsy had failed to yield an answer. Demographic, radiographic, thoracoscopic, histological and immunophenotyping data of 10 NHL patients with MPE were then retrospectively analyzed...
December 2017: Oncology Letters
https://www.readbyqxmd.com/read/29340490/accuracy-of-closed-pleural-biopsy-in-the-diagnosis-of-malignant-pleural-effusion
#15
Renata Báez-Saldaña, Uriel Rumbo-Nava, Araceli Escobar-Rojas, Patricia Castillo-González, Santiago León-Dueñas, Teresa Aguirre-Pérez, María Eugenia Vázquez-Manríquez
OBJECTIVE: Previous studies have demonstrated that closed pleural biopsy (CPB) has a sensitivity of less than 60% for diagnosing malignancy. Therefore, controversy has recently emerged regarding the value of CPB as a diagnostic test. Our objective was to assess the accuracy of CPB in diagnosing malignancy in patients with pleural effusion. METHODS: This was a prospective 8-year study of individuals who underwent CPB to establish the etiology of pleural effusion...
November 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/29320805/success-rate-of-medical-thoracoscopy-and-talc-pleurodesis-in-malignant-pleurisy-a-single-centre-experience
#16
Joke Leemans, Christophe Dooms, Vincent Ninane, Jonas Yserbyt
BACKGROUND AND OBJECTIVE: Malignant pleurisy is associated with advanced oncological disease and dyspnoea is the most common presenting symptom. Pleurodesis is the preferred palliative and supportive treatment option, targeting symptom relief. The identification of clinical and endoscopic features that determine the success of talc pleurodesis in malignant pleurisy could guide clinical decision-making. METHODS: All symptomatic patients with malignant pleurisy subjected to talc pleurodesis through medical thoracoscopy between January 2012 and December 2015 were included...
January 10, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29319243/to-study-efficacy-of-medical-thoracoscopy-in-undiagnosed-pleural-effusions
#17
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. Objectives: 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 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29318136/pleural-tuberculosis-medical-thoracoscopy-greatly-increases-the-diagnostic-accuracy
#18
Angelo Gianni Casalini, Pier Anselmo Mori, Maria Majori, Miriam Anghinolfi, Enrico Maria Silini, Letizia Gnetti, Federica Motta, Sandra Larini, Sara Montecchini, Roberta Pisi, Adriana Calderaro
Our objective was to evaluate the efficacy of a standardised work-up in the diagnosis of pleural tuberculosis (TB) that included fibreoptic bronchoscopy and medical thoracoscopy. A consecutive series of 52 pleural TB patients observed during the period 2001-2015 was evaluated retrospectively. 20 females, mean (range) age 39.7 (18-74) years, and 32 males, mean (range) age 45.75 (21-83) years, were included (28 non-EU citizens (53.8%)). The diagnosis of TB infections was established by identification (using stains, culture or molecular tests) of Mycobacterium tuberculosis in the pleura, sputum and/or bronchial specimens, or by evidence of caseous granulomas on pleural biopsies...
January 2018: ERJ Open Research
https://www.readbyqxmd.com/read/29261578/cryobiopsy-of-the-pleura-an-improved-diagnostic-tool
#19
Syed Z Tousheed, Poojaramuddanahally Hanumantharayappa Manjunath, Sagar Chandrasekar, Bangalore Venkatraman Murali Mohan, Hemanth Kumar, Kedar R Hibare, Ranganatha Ramanjaneya
BACKGROUND: Medical thoracoscopy (rigid and semirigid pleuroscopy) has revolutionized the approach to the diagnosis of pleural disease by offering a very high diagnostic yield. Rigid pleuroscopy offers the advantages of therapeutic intervention and larger biopsy specimens, whereas semirigid pleuroscopy using a standard biopsy forceps yields smaller and more superficial pleural samples. Cryobiopsy through semirigid pleuroscope in anecdotal studies has been used to overcome these disadvantages...
January 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29225889/efficacy-of-sonographic-and-biological-pleurodesis-indicators-of-malignant-pleural-effusion-simple-protocol-of-a-randomised-controlled-trial
#20
Ioannis Psallidas, Hania E G Piotrowska, Ahmed Yousuf, Nikolaos I Kanellakis, Gayathri Kagithala, Seid Mohammed, Lei Clifton, John P Corcoran, Nicky Russell, Melissa Dobson, Robert F Miller, Najib M Rahman
Introduction: Malignant pleural effusion (MPE) is common and currently in UK there are an estimated 50 000 new cases of MPE per year. Talc pleurodesis remains one of the most popular methods for fluid control. The value of thoracic ultrasound (TUS) imaging, before and after pleurodesis, in improving the quality and efficacy of care for patients with MPE remains unknown. Additionally, biomarkers of successful pleurodesis including measurement of pleural fluid proteins have not been validated in prospective studies...
2017: BMJ Open Respiratory Research
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