Abstract
Thoracoscopy is an increasingly common procedure that provides significant clinical
information and therapeutic applications. The procedure allows the physician to biopsy
the parietal pleura under direct visualization with high accuracy. In addition, one
can drain pleural fluid, place a chest tube in a precise location, and perform poudrage
pleurodesis. Medical thoracoscopy (MT) is carried out in the operating room or procedure
suite under moderate sedation with spontaneous ventilation. In comparison, video-assisted
thoracoscopic surgery (VATS) is performed under general anesthesia with single lung
ventilation and through multiple ports in the operating room. MT is less invasive,
has a comparable diagnostic yield, and may be better tolerated in high-risk patients.
The indications, complications, and advances in thoracoscopy will be discussed in
this article. In the era of rapidly evolving therapeutics for lung cancer, immune-modulation
and ever-increasing risks of immunosuppression, MT will evolve and continue to play
a pivotal role in the evaluation and research of pleuropulmonary diseases.
Keywords
thoracoscopy - pleural effusion - video-assisted thoracoscopic surgery (VATS) - pleuroscopy
- malignant pleural effusion - empyema
