Pleuroscopy: our initial experience in Hong Kong

WL Law, Johnny WM Chan, Samuel Lee, CK Ng, CK Lo, WK Ng, KK Ho, Thomas YW Mok
Department of Medicine, Queen Elizabeth Hospital, Kowloon, 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.

Hong Kong Med J 2008;14:178-84

Key words: Pleural diseases; Pleural effusion; Safety; Thoracoscopy