Outpatient pleuroscopy: Report of an experience in a referral hospital

Pleuroscopy is a safe diagnostic procedure for evaluation of pleural diseases, with minimum complications. This procedure has been recently conducted on outpatient basis. Results support its safety, especially in busy referral hospitals. We aimed to report our experience on performing outpatient pleuroscopy at Masih Daneshvari hospital; Tehran, Iran. All eligible patients referred to Masih Daneshvari Hospital for pleuroscopy between May 2015 and May 2016 were enrolled. Air evacuation was conducted in operating room though a thin Nelaton catheter attached to low pressure suction. Compression dressing using Vaseline gauze was done after air leak terminated. Patients were discharged if first chest x-ray was negative for pneumothorax and were advised to stay in touch and return 12 hours later for second chest radiograph. Baseline characteristics, radiographic and pathologic reports were reviewed. Outpatient pleuroscopy was conducted on 10 patients. Average procedure time was 22±9 minutes. All patients were discharged after 4 hours. Eight of the patients remained free of complications after 12 hours, and 2 patients presented with pneumothorax (both who had massive pleural effusion) and were successfully managed by our team. Considering pathologic diagnosis, pleural tuberculosis was as common diagnosis as malignancy in our patients (4 patients), adenocarcinoma was the most malignancy reported (3 out of 4 patients). Chronic nonspecific inflammation was reported by our pathologist in 2 cases. Outpatient pleuroscopy can be conducted safely and effectively, reducing the number of unnecessary hospitalizations in a referral center. Closed follow up, patient education and proper patient selection are necessary for minimizing complications.