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Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
Published on: November 10, 2023
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Dry Medical Thoracoscopy with Artificial Pneumothorax Induction Using Veress Needle
Nai-Chien Huan1, Sze Shyang Kho2, Larry Ellee Nyanti1,3
1Department of Respiratory Medicine, Queen Elizabeth Hospital, Kota Kinabalu, Malaysia.
Tuberculosis and Respiratory Diseases
|November 14, 2024
Summary
Veress needle use for dry medical thoracoscopy (MT) with thoracic ultrasonography (TUS) guidance is safe and effective. This technique allows for successful pleural biopsies, even in cases without significant effusion, with no reported complications.
Area of Science:
- Thoracic Surgery
- Pulmonology
- Medical Procedures
Background:
- Conventional medical thoracoscopy (MT) carries risks of lung injury without significant pleural effusion.
- Dry MT induces artificial pneumothorax to mitigate these risks.
- Veress needle use for dry MT is not widely reported.
Purpose of the Study:
- To evaluate the feasibility and safety of dry MT using Veress needle with thoracic ultrasonography (TUS) guidance.
- To assess procedural success and complication rates.
Main Methods:
- Retrospective analysis of 31 patients undergoing dry MT.
- Artificial pneumothorax induced using Veress needle under TUS guidance.
- Technical success defined by pneumothorax induction, scope insertion, and absence of immediate/delayed complications.
Main Results:
- 80.6% technical success rate for pneumothorax induction in 25 cases.
- Biopsies were successfully performed in all cases.
- No procedural complications were reported; common diagnoses included malignancy, inflammatory pleuritis, and tuberculosis.
Conclusions:
- Thoracic ultrasonography-guided dry MT with a Veress needle is technically feasible.
- The procedure is secure when performed by experienced practitioners.
- This method offers a safe alternative for pleural biopsies.
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