Role of medical thoracoscopy in the treatment of complicated parapneumonic effusions
Objective: The role of medical thoracoscopy in the treatment of pleural infections is increasingly being recognized. This study was done to assess the role of medical thoracoscopy in the management of carefully selected subset of patients with complicated parapneumonic effusions (PPEs). Materials an...
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Wolters Kluwer Medknow Publications
2021-01-01
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doaj-110b707b4f974f3f829bb532daf60d382021-03-31T07:30:25ZengWolters Kluwer Medknow PublicationsLung India0970-21130974-598X2021-01-0138214915310.4103/lungindia.lungindia_543_20Role of medical thoracoscopy in the treatment of complicated parapneumonic effusionsRamanjaneya RanganathaSyed Zulkharnain TousheedBangalore Venkatraman MuraliMohanMuhammed ZuhaibDeepika ManivannanB R HarishPoojaramuddanahally Hanumantharayappa ManjunathKedar R HibareHemanth KumarChandrasekar SagarVellaichamy Muthupandi AnnapandianObjective: The role of medical thoracoscopy in the treatment of pleural infections is increasingly being recognized. This study was done to assess the role of medical thoracoscopy in the management of carefully selected subset of patients with complicated parapneumonic effusions (PPEs). Materials and Methods: We analyzed retrospective data of 164 thoracoscopic procedures performed at our center on patients with complicated PPE in the past 10 years. Patients were subjected to medical thoracoscopy based on ultrasonographic stratification and a computed tomography (CT) thorax. Medical thoracoscopy was performed after an intercostal block under conscious sedation with midazolam (2 mg) and fentanyl (50 mcg) and local anesthesia with lignocaine 2% (10–15 ml), through a single port 10 mm diameter thoracoscope. Results: A total of 164 patients (119 males and 45 females) underwent medical thoracoscopy during the study period. The mean age was 47.4 ± 15.9 (median, 50; range, 16–86). The final diagnosis by thoracoscopy was bacterial empyema in 93 patients and tuberculosis in 71 patients. Medical thoracoscopy was successful without subsequent intervention in 160 (97.5%) patients, two patients underwent a second procedure, in the form of decortication, and two patients died due to sepsis. There were no major procedure-related complications that required intervention. Conclusion: Early adhesiolysis and drainage of fluid using medical thoracoscopy should be considered in patients with multiloculated complicated PPE after careful radiological (ultrasonography and CT) stratification, as a more cost-effective and safe method of management.http://www.lungindia.com/article.asp?issn=0970-2113;year=2021;volume=38;issue=2;spage=149;epage=153;aulast=Ranganathaconscious sedationloculationsmedical thoracoscopyparapneumonic effusions |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ramanjaneya Ranganatha Syed Zulkharnain Tousheed Bangalore Venkatraman MuraliMohan Muhammed Zuhaib Deepika Manivannan B R Harish Poojaramuddanahally Hanumantharayappa Manjunath Kedar R Hibare Hemanth Kumar Chandrasekar Sagar Vellaichamy Muthupandi Annapandian |
spellingShingle |
Ramanjaneya Ranganatha Syed Zulkharnain Tousheed Bangalore Venkatraman MuraliMohan Muhammed Zuhaib Deepika Manivannan B R Harish Poojaramuddanahally Hanumantharayappa Manjunath Kedar R Hibare Hemanth Kumar Chandrasekar Sagar Vellaichamy Muthupandi Annapandian Role of medical thoracoscopy in the treatment of complicated parapneumonic effusions Lung India conscious sedation loculations medical thoracoscopy parapneumonic effusions |
author_facet |
Ramanjaneya Ranganatha Syed Zulkharnain Tousheed Bangalore Venkatraman MuraliMohan Muhammed Zuhaib Deepika Manivannan B R Harish Poojaramuddanahally Hanumantharayappa Manjunath Kedar R Hibare Hemanth Kumar Chandrasekar Sagar Vellaichamy Muthupandi Annapandian |
author_sort |
Ramanjaneya Ranganatha |
title |
Role of medical thoracoscopy in the treatment of complicated parapneumonic effusions |
title_short |
Role of medical thoracoscopy in the treatment of complicated parapneumonic effusions |
title_full |
Role of medical thoracoscopy in the treatment of complicated parapneumonic effusions |
title_fullStr |
Role of medical thoracoscopy in the treatment of complicated parapneumonic effusions |
title_full_unstemmed |
Role of medical thoracoscopy in the treatment of complicated parapneumonic effusions |
title_sort |
role of medical thoracoscopy in the treatment of complicated parapneumonic effusions |
publisher |
Wolters Kluwer Medknow Publications |
series |
Lung India |
issn |
0970-2113 0974-598X |
publishDate |
2021-01-01 |
description |
Objective: The role of medical thoracoscopy in the treatment of pleural infections is increasingly being recognized. This study was done to assess the role of medical thoracoscopy in the management of carefully selected subset of patients with complicated parapneumonic effusions (PPEs). Materials and Methods: We analyzed retrospective data of 164 thoracoscopic procedures performed at our center on patients with complicated PPE in the past 10 years. Patients were subjected to medical thoracoscopy based on ultrasonographic stratification and a computed tomography (CT) thorax. Medical thoracoscopy was performed after an intercostal block under conscious sedation with midazolam (2 mg) and fentanyl (50 mcg) and local anesthesia with lignocaine 2% (10–15 ml), through a single port 10 mm diameter thoracoscope. Results: A total of 164 patients (119 males and 45 females) underwent medical thoracoscopy during the study period. The mean age was 47.4 ± 15.9 (median, 50; range, 16–86). The final diagnosis by thoracoscopy was bacterial empyema in 93 patients and tuberculosis in 71 patients. Medical thoracoscopy was successful without subsequent intervention in 160 (97.5%) patients, two patients underwent a second procedure, in the form of decortication, and two patients died due to sepsis. There were no major procedure-related complications that required intervention. Conclusion: Early adhesiolysis and drainage of fluid using medical thoracoscopy should be considered in patients with multiloculated complicated PPE after careful radiological (ultrasonography and CT) stratification, as a more cost-effective and safe method of management. |
topic |
conscious sedation loculations medical thoracoscopy parapneumonic effusions |
url |
http://www.lungindia.com/article.asp?issn=0970-2113;year=2021;volume=38;issue=2;spage=149;epage=153;aulast=Ranganatha |
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