Medical thoracoscopy: Experiences in Siriraj Hospital

Abstract

Objective: Medical thoracosopy is the investigational and therapeutic procedure for many kinds of pleural diseases. One of its indications is for the diagnosis of undetermined pleural effusion. We report our experience in using medical thoracoscopy in investigating undiagnosed pleural effusion. Material and Method: Thirty four consecutive patients had thoracoscopy done for this indication from 1999 to 2005. Result: Malignancy was diagnosed in 21 patients. Pleural biopsies showed chronic pleuritis in 7 patients. Normal thoracoscopy was found in 2 cases and the procedures were unsuccessful in 4 cases because of extensive pleural adhesion. In patients with malignancy, pleural nodules had a tendency to be localized in the lower part of the pleural cavity. Better selection of the patient should lower the unsuccessful procedure. Conclusion: The review of the indication for thoracoscopy will increase the use of this procedure in respiratory medicine practice and shorten the investigation time.