Dry Medical Thoracoscopy with Artificial Pneumothorax Induction: A Scoping Review.

Abstract

Background: Dry medical thoracoscopy (MT) allows access into the pleural cavity in the absence of effusion; but its role, safety, and techniques remain poorly defined. This scoping review summarises current evidence on indications, procedural approaches, diagnostic yield, and safety of dry MT; and highlights gaps to guide future research.

Methods: We conducted a scoping review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. PubMed and Google Scholar databases were systematically searched for original studies reporting on dry MT involving pneumothorax induction. Study selection and data extraction followed the Joanna Briggs Institute methodology.

Results: Thirteen studies involving 357 patients were included. 146 cases (40.9%) were completely 'dry' (complete absence of pleural fluid). Techniques for pneumothorax induction varied, including blunt dissection, Veress needle, Boutin needle, bladeless trocar, Saugman cannula and guidewire-assisted catheter insertion. Procedural success ranged from 80.6% to 100%, though definitions were inconsistently reported. Thoracic ultrasound was frequently used for site selection and needle guidance, but standardised criteria were lacking. Malignancy and chronic pleurisy were common histological findings. Complications occurred in 5.9% of cases, most commonly chest pain. No studies reported long-term follow-up.

Conclusion: Dry MT appears technically feasible and generally safe. Heterogeneity in techniques, outcome definitions, and limited follow-up constrain further interpretation. Future studies should aim to standardise procedural definitions, evaluate predictors of success, and compare pneumothorax induction methods. Prospective research with long-term outcomes is needed to definite the role of dry MT more clearly.