Chest
Clinical Investigations; Articles; Thoracic SurgeryThoracoscopy: A Prospective Study of Safety and Outcome
Section snippets
Patients
Included in this study were all patients with pleural effusions of unknown etiology, suspected or proven empyema, or recurrent malignant pleural effusions requiring pleurodesis who were referred to the Pulmonary Special Procedures Unit of University of California San Diego Medical Center, San Diego, for thoracoscopy after less invasive means of diagnosis or therapy had failed.
Techniques
Procedures were usually performed in the operating room with patients under general anesthesia after intubation with a
Results
Fifty patients (34 men and 16 women) underwent 52 total procedures during a 15-month period. One patient had two consecutive ipsilateral procedures: the first for diagnosis and the second for pleurodesis. Another had bilateral procedures. Median age was 60 years (range, 18 to 88 years). Thoracoscopy was performed with the patient under general anesthesia with selective endobronchial intubation in 40 instances. General anesthesia with spontaneous ventilation was used in eight patients, and local
Discussion
Recognized for decades in Europe, thoracoscopy for diagnosis and management of pleural processes generally has been considered to be a safe procedure.6,7 Until the recent flurry of articles pertaining to video-assisted thoracic surgery,8, 9, 10 few investigations were specifically designed to determine the frequency of procedure-related complications. Of 102 patients undergoing thoracoscopy under local anesthesia, hemodynamic compromise or persistent air leak requiring thoracotomy was reported
ACKNOWLEDGMENTS
The author thanks Ken Moser and Tames Harrell for their constant support; Chris Lewis and Nancy Brewer for their help in data collection; and the Fellows of the University of California San Diego Pulmonary Division, San Diego, for their enthusiasm.
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