Chest
Clinical InvestigationsInvestigation of Pleural Effusion: An Evaluation of the New Olympus LTF Semiflexible Thoracofiberscope and Comparison With Abram's Needle Biopsy
Section snippets
Study Setting and Patient Selection
Patients were recruited from the Respiratory Clinic at Gartnavel General Hospital in the west of Glasgow. The clinic serves a population of 250,000, many of whom have had shipyard asbestos exposure.
Twenty-four patients (5 female), aged 25 to 85 years, were investigated. All patients had pleural effusion of unknown cause. The most common reason for referral was suspicion of malignancy. Results of fluid cytologic studies had been negative in all cases. Patients were included if they were fit
The Thoracofiberscope in Use
The plastic trocar and tube were easy to insert. The flexibility of the trocar tube in the chest wall allowed more freedom to move the thoracofiberscope than found with metal trocar tubes. The viewing quality was comparable to that from a conventional fiberoptic bronchoscope and allowed abnormal areas to be identified. However, lighting was not as good as that obtainable from rigid thoracoscopes. The main body handled like a rigid thoracoscope while the flexible tip allowed the entire pleural
Discussion
Thoracoscopy is not used routinely by pulmonologists in either the United States or the United Kingdom, but it is used more widely in continental Europe.2 Most US and UK pulmonologists, however, are experienced in closed needle biopsy. We wanted to compare the current standard method of obtaining pleural tissue by closed needle biopsy with this new technique and also determine its ease of use.
Physician-performed thoracoscopy can be used to obtain pleural and lung tissue4 and, under general
Conclusion
The thoracofiberscope can be used by the physician in the ward or clinic sideroom, with less equipment than that needed for rigid thoracoscopy and without serious complications. Although optical quality is not quite as good as in rigid thoracoscopy, a greater area of pleura can be seen from one entry site. Histologic yield may be better in malignant pleural disease than with closed Abram's needle biopsy, but yield could be improved by a larger biopsy channel.
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The authors received no financial support for this study, however, Olympus Optical Co Ltd, Tokyo, Japan, provided the LTF Semi-Flexible Thoracofiberscope.