-
Thorax Nov 2023
Topics: Humans; Pleural Diseases; Pleural Effusion
PubMed: 37553157
DOI: 10.1136/thorax-2023-220304 -
The New England Journal of Medicine May 2018
Topics: Humans; Pleural Diseases
PubMed: 29719174
DOI: 10.1056/NEJMc1803858 -
The New England Journal of Medicine May 2018
Topics: Humans; Pleural Diseases; Pleural Effusion
PubMed: 29722519
DOI: 10.1056/NEJMc1803858 -
The New England Journal of Medicine May 2018
Topics: Humans; Pleural Diseases; Pleural Effusion
PubMed: 29722518
DOI: 10.1056/NEJMc1803858 -
The Clinical Respiratory Journal Mar 2018To describe the technique of pleuroscopy, its clinical uses such as diagnosis of exudative pleural effusion, treatment of pleural infection, treatment of pneumothorax,... (Review)
Review
OBJECTIVES
To describe the technique of pleuroscopy, its clinical uses such as diagnosis of exudative pleural effusion, treatment of pleural infection, treatment of pneumothorax, and diagnosis and pleurodesis of malignant pleural mesothelioma. Also to describe the newer techniques developed such as minothoracoscopy, semirigid thoracoscopy, narrow band imaging pleuroscopy, infrared pleuroscopy, autofluorescence pleuroscopy.
DATA SOURCE
We searched the pubmed the last decade for publications with the key words pleuroscopy, medical thoracoscopy, pneumothorax and pleuroscopy, malignant pleural mesothelioma, minothoracoscopy, semirigid thoracoscopy, autofluorescence pleuroscopy.
CONCLUSION
Medical thoracoscopy is the method of choice for investigation of the undiagnosed exudative pleural effusions. Newer techniques, such as narrow band imaging thoracoscopy, infrared thoracoscopy, autofluorescence thoracoscopy are offering a promising future for medical thoracoscopy.
Topics: Humans; Lung Neoplasms; Mesothelioma; Mesothelioma, Malignant; Narrow Band Imaging; Optical Imaging; Pleural Diseases; Pleural Effusion; Pleurodesis; Pneumothorax; Predictive Value of Tests; Thoracoscopy
PubMed: 27997741
DOI: 10.1111/crj.12597 -
Seminars in Respiratory and Critical... Aug 2023Coronavirus disease 2019 (COVID-19)-related pleural diseases are now well recognized. Since the beginning of the pandemic, increasing cases of pleural diseases including...
Coronavirus disease 2019 (COVID-19)-related pleural diseases are now well recognized. Since the beginning of the pandemic, increasing cases of pleural diseases including pneumothorax, pneumomediastinum, and pleural effusion with severe COVID-19 infection have attracted the attention of physicians and are not incidental or due to barotrauma. The complicated course of COVID-19 illness highlights the complex pathophysiological underpinnings of pleural complications. The management of patients with pneumothorax and pneumomediastinum is challenging as the majority require assisted ventilation; physicians therefore appear to have a low threshold to intervene. Conversely, pleural effusion cases, although sharing some similar patient characteristics with pneumothorax and pneumomediastinum, are in general managed more conservatively. The evidence suggests that patients with COVID-19-related pleural diseases, either due to air leak or effusion, have more severe disease with a worse prognosis. This implies that prompt recognition of these complications and targeted management are key to improve outcomes.
Topics: Humans; Pneumothorax; COVID-19; Mediastinal Emphysema; Pleural Diseases; Pleural Effusion
PubMed: 37429295
DOI: 10.1055/s-0043-1769616 -
Clinics in Chest Medicine Dec 2021Medical thoracoscopy is an effective and safe modality to visualize and sample contents of the pleural cavity. It is an outpatient procedure that can be performed while... (Review)
Review
Medical thoracoscopy is an effective and safe modality to visualize and sample contents of the pleural cavity. It is an outpatient procedure that can be performed while the patient is spontaneously breathing, with the use of local anesthesia and intravenous medications for sedation and analgesia. Medical thoracoscopy has indications in the management of a variety of pleural diseases. It is most commonly performed as a diagnostic procedure but has therapeutic applications as well. Although it has its advantages, management strategies of certain pleural diseases should take place within a multidisciplinary environment including general pulmonologists, interventional pulmonologists, and thoracic surgeons.
Topics: Humans; Pleural Diseases; Pleural Effusion; Thoracoscopy
PubMed: 34774180
DOI: 10.1016/j.ccm.2021.08.010 -
Current Opinion in Pulmonary Medicine May 2017Due to the increasing burden of pleural diseases worldwide, a personalized cost-effective management of these conditions is essential to optimize the healthcare sources.... (Review)
Review
PURPOSE OF REVIEW
Due to the increasing burden of pleural diseases worldwide, a personalized cost-effective management of these conditions is essential to optimize the healthcare sources. The current review is focused on latest evidence in diagnostic work-up and management of pleural diseases.
RECENT FINDINGS
Recent research highlights the increasing role of thoracic ultrasound in both diagnostic and therapeutic interventions and the potential suitability of cytological sampling from pleural effusions for molecular analysis, essential requirement for a satisfactory test in the era of personalized anticancer therapy. The thoracoscopic approach, by means of rigid or semirigid instruments, remains the gold standard, and attractive tools to increase diagnostic yield in semirigid pleuroscopy include insulated-tip diathermic knife and cryprobe. Talc pleurodesis and indwelling pleural catheters are the most effective interventions, and their combination, likely to result in additional benefits, is currently under investigation.
SUMMARY
Because of the huge variety of possible clinical settings, a proper management of pleural diseases should be tailored on a case-by-case basis and requires a multidisciplinary approach. Recent advances in technologies has conferred to interventional pulmonology an increasing relevant role in this context, leading to the development of a dedicated subspecialty, and training programs are urgently needed to standardize skills and care pathways.
Topics: Catheters, Indwelling; Humans; Pleural Diseases; Thoracoscopy
PubMed: 28257316
DOI: 10.1097/MCP.0000000000000374 -
Thorax Nov 2023
Topics: Humans; Pleural Diseases; Empyema, Pleural
PubMed: 37848216
DOI: 10.1136/thorax-2022-219630 -
Ugeskrift For Laeger Apr 2024The incidence of pleural disease is increasing and the mortality and morbidity is high. Many recent RCTs have resulted in evidence-based guidelines published in 2023,... (Review)
Review
The incidence of pleural disease is increasing and the mortality and morbidity is high. Many recent RCTs have resulted in evidence-based guidelines published in 2023, pointing towards a more individualized and specialized management. Most patients with pleural disease are admitted at the A and E but can be managed in outpatient clinics. Thus, there is a need to establish specialized, multidisciplinary pleural clinics to ensure optimal, individualized and evidence-based management of the increasing number of patients with pleural disease in Denmark, as argued in this review.
Topics: Humans; Ambulatory Care Facilities; Pleural Diseases; Denmark
PubMed: 38606707
DOI: 10.61409/V09230618