Usefulness of Thoracoscopic Pleural Biopsy for Carcinomatous Pleurisy Under Local Anesthesia

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Background. Although blind biopsies with Cope's needle were performed in the past, their diagnostic rate was low. We directly examine the thoracic cavity by thoracoscopy under local anesthesia, perform pleural biopsy, and make a definitive pathological diagnosis in carcinomatous pleurisy. Methods. We performed a retrospective study of 34 patients who had been given a diagnosis of malignant tumor are result of thoracoscopy in our hospital between January 1995 and November 2004. Results. The subjects consisted of 21 men and 13 women, ranging in age from 42 to 91 years, with a mean of 61 years. The right and left sides were involved in 16 and 18 patients, respectively. The operation times were 19 to 102 min, with a mean of 41 min. Lung cancer with pleural dissemination was diagnosed in 25 patients (primary lung carcinoma in 24 patients and metastatic lung tumor in 1 patient), and malignant pleural mesothelioma in 9 patients (biphasic-type in 5 patients and epithelioid-type in 4 patients). Nine (36%) of 25 cases of lung cancer with pleural dissemination were successfully diagnosed by pleural biopsy with pathological examination alone. Conclusions. Pleural biopsy by thoracoscopy under local anesthesia should be actively performed in patients with suspected malignant neoplastic lesions of the pleura, because the technique has a high diagnostic rate, and can be easily and safely performed with little burden on the patient.
日本呼吸器内視鏡学会の論文
2006-03-25

Usefulness of Thoracoscopic Pleural Biopsy for Carcinomatous Pleurisy Under Local Anesthesia

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