Endoscopy and Pulmology Department, University Clinic Golnik, Slovenia.
Intensive Care Department, University Clinic Golnik, Slovenia.
Radiol Oncol. 2014 Jan 22;48(1):67-71. doi: 10.2478/raon-2013-0068. eCollection 2014 Mar.
Thoracoscopy with a semirigid instrument is a recent technique for diagnosing pleural diseases. The purpose of this study was to report diagnostic yield and complications of the method.
Patients with pleural effusion of unknown origin and/or pleural irregularities suspicious for pleural malignancy were included after less invasive means of diagnosis had failed. All procedures were performed under local anaesthesia with intravenous sedation/analgesia with a single point of entry with a semirigid thoracoscope (Olympus LTF-160). Data were collected prospectively between 2008 and 2012.
One hundred fifteen thoracoscopies were performed on 111 patients. The median age was 65 years (range 28-86 years), 14.4% were female and 85.6% male. Seventy-three (65.8%) patients had malignant pleural disease (malignant mesothelioma, metastatic cancer) and 38 (34.2%) had benign disease. The sensitivity, negative predictive value, and accuracy of the procedure for malignancy were 96.0%, 93.0%, and 97.4% respectively. Pleurodesis was carried out in 34 patients; in 32 (94.1%) it was assessed as successful after 1 month. There were 24 adverse events: three empyemas/pleural infections, three bronchopleural fistulae after chest tube placement and lung re-expansion, five patients had excessive pain after pleurodesis, six patients had sedation-associated hypotension, and seven patients had self-limited fever after plerodesis. One patient died 11 days after a procedure for advanced carcinoma.
Semirigid thoracoscopy is an accurate and safe method for evaluation of pleural diseases and useful for therapeutic talc pleurodesis.
胸腔镜检查与半刚性仪器是一种最近的技术，用于诊断胸膜疾病。本研究的目的是报告该方法的诊断效果和并发症。
患有不明原因胸腔积液和/或胸膜不规则怀疑为胸膜恶性肿瘤的患者，在其他微创诊断方法失败后纳入研究。所有程序均在局部麻醉下进行，静脉镇静/镇痛，单点进入，使用半刚性胸腔镜（Olympus LTF-160）。数据在 2008 年至 2012 年期间进行前瞻性收集。
111 名患者共进行了 115 次胸腔镜检查。中位年龄为 65 岁（范围 28-86 岁），14.4%为女性，85.6%为男性。73 例（65.8%）患者患有恶性胸膜疾病（恶性间皮瘤，转移性癌症），38 例（34.2%）患有良性疾病。该程序对恶性肿瘤的敏感性、阴性预测值和准确性分别为 96.0%、93.0%和 97.4%。34 例患者进行了胸膜固定术；在 32 例（94.1%）中，1 个月后评估为成功。共有 24 例不良事件：3 例脓胸/胸膜感染，3 例放置胸腔引流管和肺复张后支气管胸膜瘘，5 例胸膜固定术后疼痛过度，6 例镇静相关低血压，7 例胸膜固定术后发热自行缓解。1 例晚期癌患者在手术后 11 天死亡。
半刚性胸腔镜检查是一种准确、安全的胸膜疾病评估方法，对滑石粉胸膜固定术有治疗作用。
