The use and development of medical thoracoscopy in the United Kingdom over the past 5 years.

INTRODUCTION

Medical thoracoscopy is a safe, reliable and therapeutic procedure used in the management of pleural disease. For reasons that are unclear it is under utilised in the United Kingdom (UK) when compared to the rest of Europe. We have studied its development and use over the past 5 years.

METHOD

We have performed national postal surveys in 1999 and 2004 to assess the provision of medical thoracoscopy, its indications for use, local practices as well as, training and audit issues.

RESULTS

11 centres in 1999 and 17 centres in 2004 perform medical thoracoscopy, there were more district general hospitals providing this service than teaching hospitals. Twenty-seven centres in 1999 and 54 centres in 2004 stated plans to begin providing a service. Centres were performing between 10 and 30 thoracoscopies per year. There were differences between centres in local practices and training received. The majority of currently performing centres offered training and were interested in national audit.

DISCUSSION

This study has shown there are still only a small proportion of UK respiratory centres performing medical thoracoscopy. There is a growing interest in the procedure, however, issues regarding standardisation of care across the UK, on going competency and training have been highlighted. A British Thoracic Society (BTS) working group has been set up to address these.