The evolving role of medical thoracoscopy on therapeutic management of pleural disease.

IF 2.8 3区医学 Q2 RESPIRATORY SYSTEM

Current Opinion in Pulmonary Medicine Pub Date : 2025-01-01 Epub Date: 2024-10-23 DOI:10.1097/MCP.0000000000001129

Clare Fong, Y C Gary Lee, Nick Maskell, Pyng Lee

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引用次数: 0

Abstract

Purpose of review: The use of medical thoracoscopy (MT) has gained widespread acceptance for the diagnosis and management of pleural disease. It is less invasive compared to video-assisted thoracoscopic surgery (VATS), can be performed in the endoscopy suite and in patients who are unfit to undergo general anaesthesia. It is safe, with high diagnostic yield, and enables pulmonologists to intervene therapeutically.

Recent findings: There have been several developments in this field, particularly for malignant pleural effusions (MPE). Specifically, we discuss further techniques that can be employed during MT to distinguish between benign and malignant pleural disease. There is also potential for combined thoracoscopic talc poudrage (TTP) and indwelling pleural catheter (IPC) insertion to shorten hospital stay.

Summary: Beyond MPE, we discuss the role of MT in patients with pneumothorax and pleural infection. We discuss the advantages and disadvantages of MT over traditional practices in a variety of conditions - diagnosis of exudative pleural effusions, prevention of recurrent MPE and pneumothoraces as well as treatment of pleural infections, so as to better aid physicians in selecting the optimum procedure for patients.

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医用胸腔镜在胸膜疾病治疗管理中不断发展的作用。

审查目的：医用胸腔镜（MT）已被广泛用于胸膜疾病的诊断和治疗。与视频辅助胸腔镜手术（VATS）相比，它的创伤更小，可在内镜室进行，也适用于不适合接受全身麻醉的患者。它安全、诊断率高，并能让肺科医生进行治疗干预：最近的发现：这一领域取得了多项进展，尤其是在恶性胸腔积液（MPE）方面。具体而言，我们讨论了在 MT 过程中可用于区分良性和恶性胸膜疾病的进一步技术。此外，胸腔镜滑石粉置入术（TTP）和留置胸膜导管插入术（IPC）也有可能缩短住院时间。我们讨论了MT在诊断渗出性胸腔积液、预防复发性MPE和气胸以及治疗胸膜感染等各种情况下与传统方法相比的优缺点，以便更好地帮助医生为患者选择最佳手术方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Pulmonary Medicine 医学-呼吸系统

CiteScore

6.20

自引率

0.00%

发文量

109

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Pulmonary Medicine is a highly regarded journal offering insightful editorials and on-the-mark invited reviews, covering key subjects such as asthma; cystic fibrosis; infectious diseases; diseases of the pleura; and sleep and respiratory neurobiology. Published bimonthly, each issue of Current Opinion in Pulmonary Medicine introduces world renowned guest editors and internationally recognized academics within the pulmonary field, delivering a widespread selection of expert assessments on the latest developments from the most recent literature.