Awake sedation thoracoscopy for the diagnosis of malignant mesothelioma: a service review
Article Category: Original Papers
Published Online: Jul 02, 2019
Page range: 27 - 30
DOI: https://doi.org/10.2478/pneum-2019-0012
Keywords
© 2019 Alqallaf et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Background
Mortality from malignant mesothelioma is expected to peak in the UK in the current decade. Areas of the country which have historically high rates of industrial exposure to asbestos, such as South East Wales, are expected to bear a disproportionately high burden of mesothelioma, making a priority. Medical thoracoscopy is an effective and safe procedure, affording both a high diagnostic yield in mesothelioma and an opportunity to carry out therapeutic drainage of pleural effusion.
Methods
We evaluated the diagnostic yield and safety of medical thoracoscopy at our centre over a 5-year period from 2010 to 2015 including 104 consecutive patients.
Results
We found that thoracoscopy provided a conclusive result effected 91.6% of successful biopsies. Thoracoscopy was especially superior to pleural cytology in the diagnosis of malignant mesothelioma, revealing 37 cases when cytology suggested only 5. The procedure was particularly safe with no mortality and only 6.7% of patients experiencing minor complications such as hypotension, and more than 75% of patients tolerated the procedure with mild or no discomfort.
Conclusion
We conclude that the awake sedation thoracoscopy service at our institution is safe and effective, particularly in the diagnosis of mesothelioma, which is common in our area.