Current status of medical pleuroscopy.

Department of Respiratory Medicine, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester LE3 9QP, Leicestershire, UK.
Clinics in chest medicine (Impact Factor: 2.17). 03/2010; 31(1):165-72, Table of Contents. DOI: 10.1016/j.ccm.2009.10.001
Source: PubMed

ABSTRACT Medical pleuroscopy (MP) offers a safe and minimally invasive tool for interventional pulmonologists. It allows diagnosis of unexplained effusion, while at the same time allowing drainage and pleurodesis. It can also help in the diagnosis of diffuse interstitial disease or associated peripheral lung abnormality in the presence of effusion. It can have a therapeutic role in pneumothorax and hyperhidrosis or chronic pancreatic pain. This article reviews the technical aspects and range of applications of MP.

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    Postgraduate medical journal 03/2014; 90(1063). DOI:10.1136/postgradmedj-2013-132191 · 1.55 Impact Factor
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    ABSTRACT: Background Recurrent and persistent pleural exudates are common in clinical practice, and in a large number of patients, thoracocentesis and blind pleural biopsy procedures do not provide a definitive diagnosis. In the Western world, the majority of these exudates are malignant. Thoracoscopy today remains the gold standard technique in providing diagnosis and management in these cases. Objectives Diagnostic yield of medical thoracoscopy was evaluated in cases of undiagnosed pleural effusion. Patients and methods Semi flexible medical thoracoscopy was done for 40 patients in the period between March 2010 and October 2012 in Kobri El-Kobba Military chest Hospital through double points of entry. Results Medical thoracoscopy gave a definitive diagnosis in 38 out of 40 patients with diagnostic yield 95%. Malignancy was diagnosed in 28 patients (70%), one patient was diagnosed as empyema (2.5%), tuberculosis was found in 9 patients (22.5%), and it was non diagnostic in 2 patients (5%). The post-thoracoscopic complications in the studied group have occurred only in 4 patients (10%). Conclusion Medical thoracoscopy is a valuable tool in the diagnosis of undiagnosed exudative pleural effusion. It is a simple and safe method with high diagnostic yield and with low complication rates.
    07/2014; 63(3). DOI:10.1016/j.ejcdt.2014.04.002
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    ABSTRACT: Hepatic hydrothorax (HH) is an infrequent but a well-known complication of portal hypertension in patients with end-stage liver disease. The estimated prevalence of HH is around 4–6 % in cirrhotics. Thoracentesis and pleural fluid analysis is a must for establishing the diagnosis of this transudative effusion in the absence of primary cardiopulmonary disease. Management strategies include sodium restriction, diuretics, thoracentesis, transjugular intrahepatic portosystemic shunt, pleurodesis, and video assisted thoracic surgery in selected patients. Liver transplantation remains the ultimate definitive management paradigm. Refractory HH thus warrants prompt consideration of liver transplantation.
    Hepatology International 03/2012; 7(1). DOI:10.1007/s12072-012-9398-8 · 2.47 Impact Factor


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Jun 6, 2014