Medical Thoracoscopy

Medical Thoracoscopy

Thoracoscopy is a minimally invasive procedure traditionally performed to diagnose and/or treat pleural lung disease. Your pleura is a large, thin sheet of tissue that wraps around the outside of your lungs and lines the inside of your chest cavity. Patients with pleural thickening or pleural effusions (pleural fluid) who have lung cancer, chylothorax, lymphoma, mesothelioma, metastatic cancers, or benign conditions such as congestive heart failure, may be eligible for this procedure. Most patients have reoccurring accumulation of pleural fluid resulting in breathing issues, chest pain, cough, and the inability to lie flat. Thoracoscopy lets the physician visualize the lung pleura and diagnose the cause of the pleural fluid, which offers the ability to apply medication to prevent further fluid from returning.

Why is it used?

It can be used for the diagnosis of pleural effusion that is not able to be diagnosed by thoracentesis (fluid sampling) alone A thorough inspection of the lung and pleura can be done and biopsies of the pleura performed In specific instances, pleurodesis medications, such as talc, can be sprayed onto the pleura, which prevents pleural fluid from returning.

Technique of Medical Thoracoscopy

Medication review to ensure anticoagulants or antiplatelet agents has been appropriately held before the procedure. In patients with normal renal function, anticoagulation fully resolves usually after 5 half-lives (Table 1).10 Basic laboratory studies: prothrombin time/international normalized ratio, platelets, blood urea nitrogen, and creatinine (Table 2). Chest imaging (chest X-ray or computed tomography of the chest). Focused pleural ultrasound examination to assess the volume and characteristics of the pleural effusion and to mark the site for pleural space entry. Multidisciplinary review of cases by pulmonologists and thoracic surgeons. Informed written consent. Preoperative fasting (6 hours).

Benefits of Medical Thoracoscopy

It can be performed using general anesthesia with a breathing tube or with moderate sedation that does not require a breathing tube It allows approaches based on the patient's history, current medical conditions, or preference Thoracoscopy increases the ability to diagnose pleural disease and the cause of pleural fluid accumulation.
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