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Semin Respir Crit Care Med 2014; 35(06): 732-743
DOI: 10.1055/s-0034-1395796
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Medical Thoracoscopy

Joseph H. Skalski
1   Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota
,
Philippe J. Astoul
2   Department of Thoracic Oncology, Pleural Diseases, and Interventional Pulmonology, Hôpital Nord, Aix-Marseille University, Chemin des Bourrely, France
,
Fabien Maldonado
1   Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota
› Author Affiliations
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Publication History

Publication Date:
02 December 2014 (online)

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Abstract

The burden of pleural diseases continues to rise and affects an increasingly complex and aging patient population. As such, thoracentesis is one of the most common procedures performed by respiratory physicians, as pleural fluid analysis can establish the diagnosis of pleural effusions in approximately 75% of the cases. When a diagnosis is not reached, options include image-guided biopsies, only possible when focal pleural lesions can be identified by computed tomography or ultrasound; closed pleural biopsies, associated with a relatively low diagnostic yield; and surgical pleural biopsies, which typically require general anesthesia and a hospital stay. Medical thoracoscopy addresses some of the limitations of these techniques, allows a comprehensive pleural examination and targeted pleural biopsies, and offers the possibility of treatment of recurrence in the same setting. As such, medical thoracoscopy is ideally positioned as a valuable tool in the diagnosis of unexplained exudative pleural effusions.

Keywords

pleuroscopy - thoracoscopy - pleural biopsies - pleurodesis - malignant pleural effusions - pneumothorax