A novel instrument for the evaluation of the pleural space: an experience in 34 patients.

STUDY OBJECTIVES To test a novel semirigid pleuroscope to be used by pulmonologists for the diagnosis and treatment of pleural diseases. DESIGN Prospective study. SETTING Three tertiary referral centers for pulmonary diseases. PATIENTS Thirty-four patients who were referred for medical thoracoscopy between September 2000 and April 2001. MEASUREMENTS AND RESULTS Thirty-six procedures were performed. The most common indications were for pleurodesis of a malignant pleural effusion (53%) or for evaluation of an exudative effusion of unknown etiology (44%). All operators found the instrument easy to use. In all but one case, the images were thought to be adequate, despite the presence of adhesions in 12 patients and loculations in 8 patients. Pleural biopsies were performed in 13 patients, and talc pleurodesis procedures were performed in 25 patients. Mean (+/- SD) duration of chest tube drainage was 2.9 +/- 1.8 days postprocedure. There were no complications. CONCLUSIONS The prototype semirigid pleuroscope is a useful instrument in the diagnosis and management of pleural diseases. It is similar in design to a standard flexible bronchoscope, so the skills involved in operating the instrument should already be familiar to the practicing pulmonologist. It is compatible with existing video processors and light sources, so little additional equipment must be added to the endoscopy suite. The semirigid pleuroscope may allow for an increase in the performance of medical thoracoscopy by pulmonologists.