Objective To compare the accuracy and safety of semirigid thoracoscopy and rigid thoracoscopy in the diagnosis of unexplained pleural effusion.
Methods A prospective randomized study was conducted, in which the patients with unexplained pleural effusion were enrolled consecutively from March 2012 to March 2014 in West China Hospital. The age of the patients ranged from 18 to 75 years. After informed consent, the subjects were randomized to a semirigid thoracoscopy group or a rigid thoracoscopy group to be examined.
Results Forty-nine patients were assigned to the semirigid thoracoscopy group, and 48 patients were assigned to the rigid thoracoscopy group. After thoracoscopy procedure, 44 patients were confirmed as malignant diseases, and 48 patients were confirmed as benign diseases. The overall diagnostic accuracy was 93.9% for the semirigid procedure and 95.8% for the rigid procedure. The diagnostic sensitivity and specificity for malignancy were 96.0% and 100.0% for the semirigid thoracoscopy, and 95.2% and 100.0% for the rigid thoracoscopy, respectively, without statistical significant differences between two groups. All the patients tolerated well with minor complications after two kinds of thoracoscopy.
Conclusions The diagnostic accuracy of semirigid thoracoscopy and rigid thoracoscopy is comparable in the diagnosis of unexplained pleural diseases. The samples obtained by semirigid thoracoscopy are smaller, but adequate for pathological examination.
Citation：
TianPanwen, HanQingbing, YangXiaodong, WenFuqiang. A Comparative Study of Semirigid Thoracoscopy and Rigid Thoracoscopy in Diagnosis of Unexplained Pleural Effusion. Chinese Journal of Respiratory and Critical Care Medicine, 2015, 14(1): 68-71. doi: 10.7507/1671-6205.2015016
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Copyright © the editorial department of Chinese Journal of Respiratory and Critical Care Medicine of West China Medical Publisher. All rights reserved
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McLean AN, Bicknell SR, McAlpine LG, et al.Investigation of pleural effusion:an evaluation of the new Olympus LTF semiflexible thoracofiberscope and comparison with Abram's needle biopsy.Chest, 1998, 114:150-153.
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Rozman A, Camlek L, Kern I, et al.Semirigid thoracoscopy:an effective method for diagnosing pleural malignancies.Radiol Oncol, 2014, 48:67-71.
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Dhooria S, Singh N, Aggarwal AN, et al.A randomized trial comparing the diagnostic yield of rigid and semirigid thoracoscopy in undiagnosed pleural effusions.Respir Care, 2014, 59:756-764.
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Rozman A, Camlek L, Marc-Malovrh M, et al.Rigid versus semi-rigid thoracoscopy for the diagnosis of pleural disease:a randomized pilot study.Respirology, 2013, 18:704-710.
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Lee P, Colt HG.Rigid and semirigid pleuroscopy:the future is bright.Respirology, 2005, 10:418-425.
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Lee P, Mathur PN, Colt GH.Advances in thoracoscopy:100 years since Jacobaeus.Respiration, 2010, 79:177-186.
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- 1. McLean AN, Bicknell SR, McAlpine LG, et al.Investigation of pleural effusion:an evaluation of the new Olympus LTF semiflexible thoracofiberscope and comparison with Abram's needle biopsy.Chest, 1998, 114:150-153.
- 2. Wang Z, Tong ZH, Li HJ, et al.Semi-rigid thoracoscopy for undiagnosed exudative pleural effusions:a comparative study.Chin Med J(Engl), 2008, 121:1384-1389.
- 3. 童朝辉, 王臻, 王辰.内科胸腔镜技术及其临床应用.中华结核和呼吸杂志, 2007, 30:220-222.
- 4. Lee P, Hsu A, Lo C, et al.Prospective evaluation of flex-rigid pleuroscopy for indeterminate pleural effusion:accuracy, safety and outcome.Respirology, 2007, 12:881-886.
- 5. Law WL, Chan JWM, Lee S, et al.Pleuroscopy:our initial experience in Hong Kong.Hong Kong Med J, 2008, 14:178-184.
- 6. Rozman A, Camlek L, Kern I, et al.Semirigid thoracoscopy:an effective method for diagnosing pleural malignancies.Radiol Oncol, 2014, 48:67-71.
- 7. Dhooria S, Singh N, Aggarwal AN, et al.A randomized trial comparing the diagnostic yield of rigid and semirigid thoracoscopy in undiagnosed pleural effusions.Respir Care, 2014, 59:756-764.
- 8. Rozman A, Camlek L, Marc-Malovrh M, et al.Rigid versus semi-rigid thoracoscopy for the diagnosis of pleural disease:a randomized pilot study.Respirology, 2013, 18:704-710.
- 9. Lee P, Colt HG.Rigid and semirigid pleuroscopy:the future is bright.Respirology, 2005, 10:418-425.
- 10. Lee P, Mathur PN, Colt GH.Advances in thoracoscopy:100 years since Jacobaeus.Respiration, 2010, 79:177-186.
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