Medical thoracoscopy and its evolving role in the diagnosis and treatment of pleural disease

Vivek Murthy, Jamie L. Bessich

Research output: Contribution to journalReview article

17 Scopus citations

Abstract

Establishing the etiology of exudative pleural effusions in the setting of an unrevealing pleural fluid analysis often requires biopsies from the parietal pleura. While closed pleural biopsy (CPB) has been a popular minimally-invasive approach, it has a poor diagnostic yield, barring a diagnosis of tuberculous pleurisy. Medical thoracoscopy (MT) is a minimally-invasive ambulatory procedure performed under local anesthesia or moderate sedation which allows for direct visualization of biopsy targets as well as simultaneous therapeutic interventions, including chemical pleurodesis and indwelling tunneled pleural catheter (ITPC) placement. The excellent yield and favorable safety profile of MT has led to it replacing CPB for many indications, particularly in the management of suspected malignant pleural effusions. As experience with MT amongst interventional pulmonologists has grown, there is an increased appreciation for its important role alongside percutaneous and surgical approaches in the diagnosis and treatment of pleural disease.

Original languageEnglish (US)
Pages (from-to)S1011-S1021
JournalJournal of Thoracic Disease
Volume9
DOIs
StatePublished - Sep 1 2017
Externally publishedYes

Keywords

  • Closed pleural biopsy (CPB)
  • Local anesthetic thoracoscopy
  • Malignant pleural effusion
  • Medical thoracoscopy (MT)
  • Pleural effusion
  • Pleuroscopy

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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