Chawla Rakesh K, Kumar Mahendra, Madan Arun, Dhar Raja, Gupta Richa, Gothi Dipti, Desai Unnati, Goel Manoj, Swarankar Rajesh, Nene Amita, Munje Radha, Chaudhary Dhruv, Guleria Randeep, Hadda Vijay, Nangia Vivek, Sindhwani Girish, Chawla Rajesh, Dutt Naveen, Dalal Sonia, Gaur Shailendra Nath, Katiyar Subodh, Samaria Jai Kumar, Gupta K B, Koul Parvaiz A, Christopher D J, Roy Dhrubajyoti, Hazarika Basant, Luhadia Shanti Kumar, Jaiswal Anand, Madan Karan, Gupta Prem Parkash, Prashad B N B M, Yusuf Nasser, James Prince, Dhamija Amit, Tomar Veerotam, Parakh Ujjwal, Khan Ajmal, Garg Rakesh, Singh Sheetu, Joshi Vinod, Sarangdhar Nikhil, Chaudhary Sushmita Roy, Nayar Sandeep, Patel Anand, Gupta Mansi, Dixit Rama Kant, Jain Sushil, Gogia Pratibha, Agarwal Manish, Katiyar Sandeep, Chawla Aditya, Gonuguntala Hari Kishan, Dosi Ravi, Chinnamchetty Vijya, Jindal Apar, Sharma Shubham, Chachra Vaibhav, Samaria Utsav, Nair Avinash, Mohan Shruti, Maitra Gargi, Sinha Ashish, Kochar Rishabh, Yadav Ajit, Choudhary Gaurav, Arunachalam M, Rangarajan Amith, Sanjan Ganesh
Department of Respiratory Medicine, Critical Care and Sleep Disorders, Jaipur Golden Hospital and Saroj Super Speciality Hospital, New Delhi, India.
Department of Respiratory Medicine, Institute of Respiratory Diseases, SMS Medical College Jaipur, Rajasthan, India.
Lung India. 2024 Mar 1;41(2):151-167. doi: 10.4103/lungindia.lungindia_5_24. Epub 2024 Feb 27.
Medical Thoracoscopy (MT) is commonly performed by respiratory physicians for diagnostic as well as therapeutic purposes. The aim of the study was to provide evidence-based information regarding all aspects of MT, both as a diagnostic tool and therapeutic aid for pulmonologists across India. The consensus-based guidelines were formulated based on a multistep process using a set of 31 questions. A systematic search of published randomized controlled clinical trials, open labelled studies, case reports and guidelines from electronic databases, like PubMed, EmBase and Cochrane, was performed. The modified grade system was used (1, 2, 3 or usual practice point) to classify the quality of available evidence. Then, a multitude of factors were taken into account, such as volume of evidence, applicability and practicality for implementation to the target population and then strength of recommendation was finalized. MT helps to improve diagnosis and patient management, with reduced risk of post procedure complications. Trainees should perform at least 20 medical thoracoscopy procedures. The diagnostic yield of both rigid and semirigid techniques is comparable. Sterile-graded talc is the ideal agent for chemical pleurodesis. The consensus statement will help pulmonologists to adopt best evidence-based practices during MT for diagnostic and therapeutic purposes.
内科胸腔镜检查（MT）通常由呼吸内科医生进行，用于诊断和治疗目的。本研究的目的是为印度各地的肺科医生提供关于MT各个方面的循证信息，MT作为一种诊断工具和治疗辅助手段。基于共识的指南是通过一个多步骤过程制定的，该过程使用了一组31个问题。对已发表的随机对照临床试验、开放标签研究、病例报告以及来自电子数据库（如PubMed、EmBase和Cochrane）的指南进行了系统检索。采用改良的分级系统（1、2、3或常规实践点）对现有证据的质量进行分类。然后，考虑了众多因素，如证据量、对目标人群实施的适用性和实用性，最后确定推荐强度。MT有助于改善诊断和患者管理，降低术后并发症风险。培训学员应至少进行20例内科胸腔镜检查。硬质和半硬质技术的诊断率相当。无菌级滑石粉是化学性胸膜固定术的理想药物。该共识声明将有助于肺科医生在MT诊断和治疗过程中采用最佳的循证实践。
