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    Outcomes and complications following medical thoracoscopy

    Access Status
    Open access via publisher
    Authors
    Brims, Fraser
    Arif, M.
    Chauhan, A.
    Date
    2012
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Brims, F. and Arif, M. and Chauhan, A. 2012. Outcomes and complications following medical thoracoscopy. Clinical Respiratory Journal. 6 (3): pp. 144-149.
    Source Title
    Clinical Respiratory Journal
    DOI
    10.1111/j.1752-699X.2011.00254.x
    ISSN
    1752-6981
    School
    Curtin Medical School
    URI
    http://hdl.handle.net/20.500.11937/17994
    Collection
    • Curtin Research Publications
    Abstract

    Introduction: Thoracoscopy is an invasive procedure that may be performed by physicians for the investigation of exudative pleural effusion using local anaesthesia, conscious sedation and a rigid thoracoscope. Objectives: We sought to evaluate the safety and outcome of thoracoscopy in Portsmouth Hospitals, UK, a dockyard city with high previous asbestos usage. Methods: Retrospective casenote, radiology and laboratory result analysis of patients undergoing thoracoscopy in our institution over a 12-month period. Results: Fifty-seven of 58 casenotes were available for analysis. Median (interquartile range) age was 73.0 (66.5-79.0) years and 44 (77.2%) were male. Median time with chest drain post-procedure was 3.0 (2.0-5.0) days, and length of stay (LOS) was 4.0 (2.0-8.0) days. Malignant histology was reported in 40 (70.2%), with 25 (62.5%) cases of mesothelioma. There were no deaths related to the procedure. Hospital-acquired infection (HAI) occurred in six (10.5%: pneumonia four, empyema two), all had malignancy. The presence of HAI significantly prolonged the LOS 9.0 (7.5-23.5) vs no HAI 4.0 (2.0-7.0) days; P=0.006). Four patients died within 1 month of the procedure, three had a malignant diagnosis, all had suffered HAI. Trapped lung (persistent hydropneumothorax 5 days post-procedure) occurred in 11 (19.2%), six of whom had benign histology. Performance status (European Cooperative Oncology Group) prior did not differ with reported histological type: benign 2.0 (2.0-2.0), malignant 2.0 (2.0-3.0), P=0.170. Conclusions: Serious complications following thoracoscopy are rare. HAI is associated with malignancy and prolonged hospital stay. Benign histology may still confer significant morbidity. Please cite this paper as: Brims FJH, Arif M and Chauhan AJ. Outcomes and complications following medical thoracoscopy.

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