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Original ArticleOpen Access
Outcome of Medical Thoracoscopy
Tscheikuna J 
,
Silairatana S ,
Sangkeaw S ,
Nana A
,
Silairatana S ,
Sangkeaw S ,
Nana A Background: Medical thoracoscopy is a common procedure for pulmonologists working in Europe but is still
unpopular in South East Asia with few medical centers in Thailand performing this procedure. We report our
outcome of medical thoracoscopy based upon 10 years experience.
MAterial and Method: Medical thoracoscopy was first performed in our unit in 1998. The early indication
was undiagnosed pleural effusion. Other indications which were empyema, pneumothorax and talc pleudrage
were carried on for the last 3 years. The patients’ demographic data, indication for medical thoracoscopy,
procedures, complication and outcome were recorded and analyzed separately.
Results: During 1998 to 2007, there were142 procedures of medical pleuroscopy performed. There were 86
procedures for the indication of undiagnosed pleural effusion. The diagnostic yield was 95.2%. The malignancy
was recovered by thoracoscopy in 45.35% of procedure. For indication of talc pleurodesis, there were 22
patients with 3 who had early failure of pleurodesis because of trapped lung. After mean follow up of 124
days,17 patients did not have recurrence of pleural effusion. 15 patients who had loculated pleural effusion
were done medical thoracoscopy. Operations were successful in only 6 patients. For indication of pneumothorax
5 out of 6 procedures were successful after mean follow up of 167 days. In 12 empyema patients, mean hospital
admission was 9.1 days after thoracoscopy. There was no serious complication from the procedure.
Discussion: There are many indications for medical thoracoscopy and the experience of the performer is the
important factor determining success of the procedure. In undiagnosed pleural effusion, our result was
comparable to other studies in the past in which the rate of malignancy was around 40-60%. The result of talc
pleudrage was also comparable with the need to improve the diagnosis of trapped lung to prevent the
unnecessary medical thoracoscopy. The result was excellent in patients who came for pleurodesis indicated in
pneumothorax also in empyema but number of patient was still low. The problem was in loculated pleural
effusion from malignancy which showed high failure rate. The early pleurodesis in malignant pleural effusion
before it became loculated should be considered.
Conclusion: Outcome of medical thoracoscopy varies from various indications. The success rate was high and
decreasing in undiagnosed pleural effusion, pneumothorax, empyema and talc pleurodesis in malignant
effusion. Great skill was needed to perform medical thoracoscopy in loculated malignant pleural effusion
Keywords: Empyema, Empyema pleural, Pleural effusion, Thoracoscopy
unpopular in South East Asia with few medical centers in Thailand performing this procedure. We report our
outcome of medical thoracoscopy based upon 10 years experience.
MAterial and Method: Medical thoracoscopy was first performed in our unit in 1998. The early indication
was undiagnosed pleural effusion. Other indications which were empyema, pneumothorax and talc pleudrage
were carried on for the last 3 years. The patients’ demographic data, indication for medical thoracoscopy,
procedures, complication and outcome were recorded and analyzed separately.
Results: During 1998 to 2007, there were142 procedures of medical pleuroscopy performed. There were 86
procedures for the indication of undiagnosed pleural effusion. The diagnostic yield was 95.2%. The malignancy
was recovered by thoracoscopy in 45.35% of procedure. For indication of talc pleurodesis, there were 22
patients with 3 who had early failure of pleurodesis because of trapped lung. After mean follow up of 124
days,17 patients did not have recurrence of pleural effusion. 15 patients who had loculated pleural effusion
were done medical thoracoscopy. Operations were successful in only 6 patients. For indication of pneumothorax
5 out of 6 procedures were successful after mean follow up of 167 days. In 12 empyema patients, mean hospital
admission was 9.1 days after thoracoscopy. There was no serious complication from the procedure.
Discussion: There are many indications for medical thoracoscopy and the experience of the performer is the
important factor determining success of the procedure. In undiagnosed pleural effusion, our result was
comparable to other studies in the past in which the rate of malignancy was around 40-60%. The result of talc
pleudrage was also comparable with the need to improve the diagnosis of trapped lung to prevent the
unnecessary medical thoracoscopy. The result was excellent in patients who came for pleurodesis indicated in
pneumothorax also in empyema but number of patient was still low. The problem was in loculated pleural
effusion from malignancy which showed high failure rate. The early pleurodesis in malignant pleural effusion
before it became loculated should be considered.
Conclusion: Outcome of medical thoracoscopy varies from various indications. The success rate was high and
decreasing in undiagnosed pleural effusion, pneumothorax, empyema and talc pleurodesis in malignant
effusion. Great skill was needed to perform medical thoracoscopy in loculated malignant pleural effusion
Keywords: Empyema, Empyema pleural, Pleural effusion, Thoracoscopy
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