Semi-rigid thoracoscopy: initial experience from a tertiary care hospital

Abstract

Background: Thoracoscopy is usually carried out using rigid metallic instruments. Recently, video flex-rigid or semi-rigid thoracoscopes have been introduced. These have the advantage of easy maneuverability, although the biopsy samples are smaller as compared to those with rigid thoracoscopy. We have looked at the usefulness of flex rigid thoracoscope in the diagnosis and treatment of pleural diseases, remained undiagnosed after thoracentesis and closed biopsy.

Methods: Retrospective analysis of data of patients who underwent thoracoscopy for the evaluation of pleural disease.

Results: Thoracoscopy was done in 21 patients using a flex-rigid thoracoscope in our institution. The indication was pleural effusion with inconclusive or negative pleural fluid cytology and blind pleural biopsy in 18 of the 21 patients. Thoracoscopic biopsy was positive in 12 of the 18 patients (66.7%). Of the six who had a negative biopsy, the procedure indirectly helped in patient management in five. There were no significant procedure-related complications.

Conclusion: Thoracoscopy with flex-rigid thoracoscope is a useful diagnostic tool in the evaluation of pleural effusions with negative blind pleural biopsy and cytology.