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L V Rodrigues, G Samouco, R Gomes, C Santos, L Ferreira
If the seemingly less invasive semi-flexible pleuroscopes are combined with strategies of conscious sedation and local anesthesia the pleuroscopy has the potential to reach an increasing number of hospital settings. Local experiences can provide valuable information pertaining to the reproducibility of this technique in different scenarios. We performed a retrospective analysis of the clinical records of all patients that had undergone local anesthetic semi-flexible pleuroscopy in our unit between February 2015 and July 2017...
June 10, 2018: Pulmonology
Chia-Hung Chen, Wen-Chien Cheng, Biing-Ru Wu, Chih-Yu Chen, Wei-Chun Chen, Wei-Chih Liao, Chih-Yen Tu
Background: The aim of this study was thus to evaluate the feasibility and safety of taking biopsy specimens by cryoprobe from the parietal pleura during semirigid pleuroscope. Methods: In a single-center, observational, prospective study, patients with exudative pleural effusion (EPE) were evaluated with a semirigid pleuroscope between January 2015 and July 2017. Each patient underwent pleural biopsy using flexible forceps and flexible cryoprobe through pleuroscope following diagnostic thoracentesis and closed pleural biopsy (CPB)...
2018: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
Syed Z Tousheed, Poojaramuddanahally Hanumantharayappa Manjunath, Sagar Chandrasekar, Bangalore Venkatraman Murali Mohan, Hemanth Kumar, Kedar R Hibare, Ranganatha Ramanjaneya
BACKGROUND: Medical thoracoscopy (rigid and semirigid pleuroscopy) has revolutionized the approach to the diagnosis of pleural disease by offering a very high diagnostic yield. Rigid pleuroscopy offers the advantages of therapeutic intervention and larger biopsy specimens, whereas semirigid pleuroscopy using a standard biopsy forceps yields smaller and more superficial pleural samples. Cryobiopsy through semirigid pleuroscope in anecdotal studies has been used to overcome these disadvantages...
January 2018: Journal of Bronchology & Interventional Pulmonology
Saima Siraj, Saima Akhter, Nadeem Rizvi
The authors report a case of 50-year man who presented with 2-year history of dry cough, right sided chest pain, and shortness of breath. Chest X-ray revealed right-sided pleural effusion and left-sided opacity. Pleuroscopic pleural biopsy confirmed the diagnosis of primary pleural epitheliod hemangioendothelioma (EHE) with peripheral lung parenchymal invasion. Chest drain was inserted; and significant amount of fluid was drained, but lung failed to expand after 72 hours. Patient was planned for video assisted thoracoscopy (VATS) and also discussed with oncology department for chemotherapy; but he refused any further treatment, and left home against medical advice with chest drain in place...
September 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Talha Mahmud, Tajwar Nasir, Muhammad Saqib, Muhammad Aasim, Nasir Siddique
OBJECTIVE: For assessing the use of if simulation training on animal cadavers as a useful tool for training in pleuroscopy. METHODS: The email-based cross-sectional study was conducted in December 2014 at Shaikh Zayed Hospital, Federal Postgraduate Medical Institute, Lahore, Pakistan, and comprised respiratory physicians and trainees after their participation in a two-day hands-on training course on pleuroscopy and pleural medical procedures. The responses were analysed and the responses of physicians and trainees were compared...
April 2017: JPMA. the Journal of the Pakistan Medical Association
Xiao-Bo Wang, Yan Yin, Yuan Miao, Ralf Eberhardt, Gang Hou, Felix J Herth, Jian Kang
Diagnosing pleural effusion is challenging, especially in patients with malignant or benign fibrothorax, which is difficult to sample using standard flexible forceps (SFF) via flex-rigid pleuroscopy. An adequate sample is crucial for the differential diagnosis of malignant fibrothorax (malignant pleural mesothelioma, metastatic lung carcinoma, etc.) from benign fibrothorax (benign asbestos pleural disease, tuberculous pleuritis, etc.). Novel biopsy techniques are required in flex-rigid pleuroscopy to improve the sample size and quality...
November 2016: Journal of Thoracic Disease
Preyas J Vaidya, Arvind H Kate, Deval Mehta, Boman N Dhabar, Prashant N Chhajed
Lung cancer is the leading cause of cancer deaths worldwide, and around 75% to 80% of lung cancers are detected in advanced stage. Multiple genetic mutations are identified and reported in adenocarcinoma of the lung. Various pulmonary samples can be tested for molecular mutations in lung cancer. However, feasibility of molecular profiling of pleuroscopic pleural biopsies in lung adenocarcinoma is not reported. We describe a case of advanced adenocarcinoma of lung with positive anaplastic lymphoma tyrosine kinase mutation on pleuroscopic pleural biopsy and improved with oral crizotinib...
April 2016: Journal of Cancer Research and Therapeutics
Ilias Porfyridis, Georgios Georgiadis, Michalis Michael, Frangiskos Frangopoulos, Paris Vogazianos, Alexis Papadopoulos, Panayiota Kara, Charis Charalampous, Andreas Georgiou
BACKGROUND AND OBJECTIVE: Medical thoracoscopy (MT) is useful for the management of pleural disease. Rapid on-site evaluation (ROSE) of transbronchial needle aspirates proved to be useful during bronchoscopy. We aimed to evaluate the diagnostic performance of ROSE of MT biopsy specimens and thoracoscopists' impression of the macroscopic appearance and assess the intermodality agreement between ROSE and final histopathologic diagnosis. METHODS: Sixty two patients with exudative pleural effusions further investigated with MT were enrolled...
August 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
Pyng Lee, Praveen N Mathur
PURPOSE OF REVIEW: Medical thoracoscopy provides the physician a window into the pleural space. The procedure allows biopsy of the parietal pleura under direct visualization with good accuracy. In addition, it achieves therapeutic goals of fluid drainage, guided chest tube placement, and pleurodesis. RECENT FINDINGS: Comparable diagnostic yield is achieved with the flexi-rigid pleuroscope even though pleural biopsies are smaller using the flexible forceps as compared to rigid thoracoscopy...
May 2016: Current Opinion in Pulmonary Medicine
José M Porcel, M Azzopardi, C F Koegelenberg, F Maldonado, N M Rahman, Y C G Lee
Pleural effusions arise from a variety of systemic, inflammatory, infectious and malignant conditions. Their precise etiological diagnosis depends on a combination of medical history, physical examination, imaging tests and pertinent pleural fluid analyses; including specific biomarkers (e.g., natriuretic peptides for heart failure, adenosine deaminase for tuberculosis, or mesothelin for mesothelioma). Invasive procedures, such as pleuroscopic biopsies, may be required for persistently symptomatic effusions which remain undiagnosed after the analysis of one or more pleural fluid samples...
2015: Expert Review of Respiratory Medicine
Lalitkumar V Lad, Ahmad Toha Samsudin, Kunji Kannan, Jaafar Sadeq Makki, Moharzudi Mohamed
OBJECTIVES: This study was carried out to ascertain the aetiology of exudative pleural effusions when other diagnostic investigations such as pleural fluid and sputum examination for cytology and acid fast bacilli fail to yield a definitive diagnosis and to differentiate between tuberculosis and malignancy in cases suspicious of malignancy. METHODS: Pleuroscopic biopsies were obtained in 219 cases by Chest Physicians in the endoscopy suite using flexi-rigid fiber-optic pleuroscopes...
August 2015: Malaysian Journal of Pathology
Ziad Boujaoude, Thaddeus Bartter, Mariam Abboud, Melvin Pratter, Wissam Abouzgheib
BACKGROUND: Malignant pleural effusion (MPE) is associated with poor prognosis and it often impinges upon quality of life; effective and efficient management is desirable. Combining pleuroscopic pleurodesis (PP) with a tunneled pleural catheter (TPC) could minimize hospitalization, effect rapid pleurodesis in most cases, and allow ongoing control of MPE for those not successfully pleurodesed. METHODS: Consecutive patients with pleural effusion associated with malignancy and with documented lung reexpansion after pleural fluid drainage were prospectively enrolled to undergo PP with TPC placement...
July 2015: Journal of Bronchology & Interventional Pulmonology
Atsuko Ishida, Hirotaka Kida, Hiromi Muraoka, Hiroki Nishine, Masamichi Mineshita, Teruomi Miyazawa
Three cases of inoperable secondary spontaneous pneumothorax were diagnosed in patients with chronic obstructive pulmonary disease. Two cases initially underwent bronchial occlusion with endobronchial Watanabe spigot (EWS), while one underwent talc poudrage with pleuroscopy. As air leaks were not stopped completely in all cases with the initial procedures, we performed additional interventional treatments: pleuroscopic talc poudrage in cases when bronchial occlusion was performed first; and bronchial occlusion with EWS for a case that initially underwent talc pleurodesis...
March 2015: Respirology Case Reports
Rajesh Thomas, Shanka Karunarathne, Barton Jennings, Sue Morey, Siaw Ming Chai, Y C Gary Lee, Martin J Phillips
BACKGROUND AND OBJECTIVE: Flexi-rigid pleuroscopy is a useful tool in the work-up of pleural effusions, but pleural biopsy using flexible forceps can be difficult in some patients. This study evaluated the feasibility, safety and diagnostic value of using a flexible cryoprobe to obtain parietal pleural biopsies during pleuroscopy. METHODS: This was a single-centre retrospective study. In patients undergoing diagnostic pleuroscopy, pleural biopsy using flexible forceps, followed by a flexible cryoprobe introduced through the pleuroscope, were performed...
February 2015: Respirology: Official Journal of the Asian Pacific Society of Respirology
Robert Kyskan, Kayvan Amjadi
Pleural Disease PostersSESSION TYPE: Original Investigation PosterPRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PMPURPOSE: Medical Thoracosopy (MT) is a minimally invasive procedure which utilizes a flex-rigid pleuroscope in order to visualize the pleural space and perform biopsies for diagnostic purposes in patients with pleural disease. Many centers performing MT will insert a chest tube and admit patients to hospital after the procedure, which is less convenient for the patient, introduces risk of nosocomial infections, and creates additional health care costs...
October 1, 2014: Chest
Bashar Mourad, Hammad Bhatti, Adil Shujaat, Abubakr Bajwa
SESSION TITLE: Infectious Disease Student/Resident Case Report Posters ISESSION TYPE: Medical Student/Resident Case ReportPRESENTED ON: Tuesday, October 28, 2014 at 01:30 PM - 02:30 PMINTRODUCTION: Lymphocytic interstitial pneumonitis (LIP) is an uncommon form of interstitial lung disease in adults that is characterized histopathologically by infiltration of the interstitium and alveolar spaces by lymphocytes. Radiologically LIP is characterized by a diffuse bilateral reticular pattern, and rarely presents as a pleural effusion...
October 1, 2014: Chest
Yukio Watanabe, Shinji Sasada, Christine Chavez, Yuji Matsumoto, Takehiro Izumo, Takaaki Tsuchida
OBJECTIVE: Medical thoracoscopy using a flex-rigid pleuroscope under local anesthesia is a recent diagnostic procedure for malignant pleural disease. Although most previous studies have reported its usefulness, especially in wet pleural dissemination, the feasibility of flex-rigid pleuroscopy in patients with dry pleural dissemination is not well established.We assessed the diagnostic performance of flex-rigid pleuroscopy under local anesthesia in patients suspected of dry pleural dissemination on radiography...
August 2014: Japanese Journal of Clinical Oncology
Kim Hoong Yap, Martin J Phillips, Y C Gary Lee
PURPOSE OF REVIEW: In managing pleural diseases, medical thoracoscopy is often performed as a diagnostic and/or therapeutic procedure, particularly in undiagnosed pleural effusions. Flexi-rigid pleuroscopes are now widely available as an alternative to conventional rigid thoracoscopes. There is an ongoing debate on which is the better instrument. This review analyses the current literature that compared rigid and flexi-rigid approaches, and outlines the medical advances that may influence the future role of thoracoscopy...
July 2014: Current Opinion in Pulmonary Medicine
Kyohei Masai, Shinji Sasada, Takehiro Izumo, Tomoko Taniyama, Yukiko Nakamura, Christine Chavez, Hiroyuki Sakurai, Koji Tsuta, Takaaki Tsuchida
Desmoplastic malignant mesothelioma (DMM) is a rare subtype of malignant pleural mesothelioma (MPM) and is often difficult to distinguish from pleural fibrosis and reactive mesothelial hyperplasia, especially if the biopsy samples are small. We performed full-thickness pleural biopsy on a lesion suspected to be DMM using an insulated-tip diathermic knife-2 (IT knife-2) during flex-rigid pleuroscopy. IT knife-2 is a novel electrosurgical device for endoscopic submucosal dissection in the early gastrointestinal cancer...
October 2013: Journal of Bronchology & Interventional Pulmonology
Sahajal Dhooria, Navneet Singh, Ashutosh N Aggarwal, Dheeraj Gupta, Ritesh Agarwal
BACKGROUND: Thoracoscopic pleural biopsy increases the diagnostic yield of pleural effusions undiagnosed after thoracentesis and is superior to closed pleural biopsy. Medical thoracoscopy can be performed using the rigid thoracoscope or the semirigid thoracoscope (pleuroscope). In this randomized trial, we compare the efficacy and safety of the 2 thoracoscopes. METHODS: Subjects with undiagnosed exudative pleural effusions were randomly assigned to undergo pleural biopsy with either the rigid or the semirigid thoracoscope...
May 2014: Respiratory Care
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