Author of

• 10912

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  P1.17 - Poster Session 1 - Bronchoscopy, Endoscopy (ID 182)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Pulmonology + Endoscopy/Pulmonary
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10922

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    P1.17-010 - Diagnostic medical thoracoscopy for pleural effusions of unknown etiology: Inspection delay may cause non-deterministic endoscopic diagnosis (ID 3056)

    09:30 - 09:30  |  Author(s): T. Ishida
    • Abstract

    Background
    Thoracoscopy is a useful tool for diagnosis of exudative pleural effusion of unknown etiology, and the efficacy and safety have already been established. The procedure is relatively easy and can be performed under local anesthesia with conscious sedation. We investigated the factors associated with thoracoscopically undiagnosed patients in our hospital.

    Methods
    Clinical records were reviewed retrospectively. We found 101 patients who underwent medical thoracoscopy from April 2000 to May 2013, and then we identified 91 eligible patients for the detailed analysis. All the procedures were performed utilizing a flexible bronchoscopy (type-240, Olympus Corporation, Tokyo, Japan) or a semi-rigid thoracoscopy (LTF type-240, Olympus Corporation, Tokyo, Japan) from a single-port under local anesthesia.

    Results
    The median age of the patients was 69 years old (range, 32-89), and 79 (86.8%) were male. Affected sides of effusion were right/left/bilateral = 60/26/5. Definitive diagnoses were obtained in 73 (80.2%) cases. In 21 (23.1%) patients, the duration from the disease-onset to the examination was more than 3 months. In 18 (19.8%) thoracoscopically undiagnosed patients, the number of patients according to the time from disease-onset to the examination was as follows; none within 1 month, 7/46 patients (15.2%) in 2 to 3 months, and 11/36 patients (30.6%) in more than 4 months. No remarkable complications, other than a moderate hemoptysis, were seen.

    Conclusion
    Medical thoracoscopies were safe, and they contributed to definitive diagnoses. The delay of thoracoscopic examination from the disease-onset tended to lead non-specific findings in pathological diagnosis. Diagnostic medical thoracoscopy should be performed as soon as possible when the cause of pleural effusion is undetermined with thoracentesis.