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.