Pleuroscopy: our initial experience in Hong Kong.

OBJECTIVE: To report our preliminary experience using pleuroscopy for patients with pleural diseases.

DESIGN: Prospective cohort study.

SETTING: Tertiary referral hospital with service input from respiratory physicians and cardiothoracic surgeons in Hong Kong.

PATIENTS: Between April and November 2007, patients with undiagnosed exudative pleural effusions and proven malignant pleural effusions were recruited for diagnostic evaluations and therapeutic interventions, respectively.

INTERVENTION: Pleuroscopy with a semi-rigid thoracoscope performed under local anaesthesia and conscious sedation.

RESULTS: A total of 20 patients (16 males and 4 females; mean age, 63 years) underwent the procedure and were followed up for a mean of 19 weeks. For the 14 patients having diagnostic pleuroscopy, the yield was 79% (11 patients). The 3-month success rate for the six patients undergoing pleurodesis was 83% (five patients). Complications were mild and included self-limiting fever (20%, four patients) and localised subcutaneous emphysema (20%, four patients). No major complications or mortality were noted.

CONCLUSION: Pleuroscopy using a semi-rigid instrument is a safe and efficacious procedure for the management of pleural diseases in suitable patients.