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Semin Respir Crit Care Med 2018; 39(06): 693-703
DOI: 10.1055/s-0038-1676978
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Thoracoscopy: Advances and Increasing Role for Interventional Pulmonologists

Pyng Lee
1   Yong Loo Lin School of Medicine, National University of Singapore, Singapore
2   Division of Respiratory and Critical Care Medicine, Department of Medicine, National University Hospital, Singapore
,
Erik Folch
3   Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
› Author Affiliations
Further Information

Publication History

Publication Date:
14 January 2019 (online)

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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
 

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