Safety and Performance Characteristics of Outpatient Medical Thoracoscopy and Indwelling Pleural Catheter Insertion for Evaluation and Diagnosis of Pleural Disease at a Tertiary Center in Canada
Background. Many centers performing medical thoracoscopy (MT) to diagnose pleural disease will insert a chest tube and admit patients to hospital after the procedure, which is inconvenient for patients and contributes to healthcare costs. We report the data on the safety, outcomes, and performance c...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Canadian Respiratory Journal |
| Online Access: | http://dx.doi.org/10.1155/2017/9345324 |
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| author | Robert Kyskan Pen Li Sunita Mulpuru Carolina Souza Kayvan Amjadi |
| author_facet | Robert Kyskan Pen Li Sunita Mulpuru Carolina Souza Kayvan Amjadi |
| author_sort | Robert Kyskan |
| collection | DOAJ |
| description | Background. Many centers performing medical thoracoscopy (MT) to diagnose pleural disease will insert a chest tube and admit patients to hospital after the procedure, which is inconvenient for patients and contributes to healthcare costs. We report the data on the safety, outcomes, and performance characteristics of outpatient MT with indwelling pleural catheter (IPC) insertion in a large Canadian cohort. Methods. This retrospective cohort study reviewed patients who underwent outpatient MT and IPC insertion under conscious sedation. Patients without complications were discharged the same day. We report the data on safety, outcomes, and performance characteristics of our program. Results. Outpatient MT and IPC insertion was performed on 218 patients. 99.1% of patients were safely discharged the same day. There was no procedure associated mortality. Pleural malignancy (59.6%) and nonspecific pleuritis (29.4%) were the most common pathologies. Pleural nodularity detected endoscopically was excellent at predicting malignancy with a positive predictive value of 92.5% and is more frequently detected endoscopically when compared to CT scan (p<0.001). Conclusions. In the setting of a comprehensive pleural disease program, outpatient MT can be safely performed and is an alternative to an inpatient surgical approach for undiagnosed pleural effusions. |
| format | Article |
| id | doaj-art-7430dacc3007427a9308d6b63e5342c5 |
| institution | Kabale University |
| issn | 1198-2241 1916-7245 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Respiratory Journal |
| spelling | doaj-art-7430dacc3007427a9308d6b63e5342c52025-02-03T01:00:40ZengWileyCanadian Respiratory Journal1198-22411916-72452017-01-01201710.1155/2017/93453249345324Safety and Performance Characteristics of Outpatient Medical Thoracoscopy and Indwelling Pleural Catheter Insertion for Evaluation and Diagnosis of Pleural Disease at a Tertiary Center in CanadaRobert Kyskan0Pen Li1Sunita Mulpuru2Carolina Souza3Kayvan Amjadi4Department of Medicine, Division of Respirology, University of British Columbia, Vancouver, BC, CanadaDepartment of Medicine, Division of Respirology, University of Alberta, Edmonton, AB, CanadaDepartment of Medicine, Division of Respirology, University of Ottawa, Ottawa, ON, CanadaDepartment of Radiology, University of Ottawa, Ottawa, ON, CanadaDepartment of Medicine, Division of Respirology, University of Ottawa, Ottawa, ON, CanadaBackground. Many centers performing medical thoracoscopy (MT) to diagnose pleural disease will insert a chest tube and admit patients to hospital after the procedure, which is inconvenient for patients and contributes to healthcare costs. We report the data on the safety, outcomes, and performance characteristics of outpatient MT with indwelling pleural catheter (IPC) insertion in a large Canadian cohort. Methods. This retrospective cohort study reviewed patients who underwent outpatient MT and IPC insertion under conscious sedation. Patients without complications were discharged the same day. We report the data on safety, outcomes, and performance characteristics of our program. Results. Outpatient MT and IPC insertion was performed on 218 patients. 99.1% of patients were safely discharged the same day. There was no procedure associated mortality. Pleural malignancy (59.6%) and nonspecific pleuritis (29.4%) were the most common pathologies. Pleural nodularity detected endoscopically was excellent at predicting malignancy with a positive predictive value of 92.5% and is more frequently detected endoscopically when compared to CT scan (p<0.001). Conclusions. In the setting of a comprehensive pleural disease program, outpatient MT can be safely performed and is an alternative to an inpatient surgical approach for undiagnosed pleural effusions.http://dx.doi.org/10.1155/2017/9345324 |
| spellingShingle | Robert Kyskan Pen Li Sunita Mulpuru Carolina Souza Kayvan Amjadi Safety and Performance Characteristics of Outpatient Medical Thoracoscopy and Indwelling Pleural Catheter Insertion for Evaluation and Diagnosis of Pleural Disease at a Tertiary Center in Canada Canadian Respiratory Journal |
| title | Safety and Performance Characteristics of Outpatient Medical Thoracoscopy and Indwelling Pleural Catheter Insertion for Evaluation and Diagnosis of Pleural Disease at a Tertiary Center in Canada |
| title_full | Safety and Performance Characteristics of Outpatient Medical Thoracoscopy and Indwelling Pleural Catheter Insertion for Evaluation and Diagnosis of Pleural Disease at a Tertiary Center in Canada |
| title_fullStr | Safety and Performance Characteristics of Outpatient Medical Thoracoscopy and Indwelling Pleural Catheter Insertion for Evaluation and Diagnosis of Pleural Disease at a Tertiary Center in Canada |
| title_full_unstemmed | Safety and Performance Characteristics of Outpatient Medical Thoracoscopy and Indwelling Pleural Catheter Insertion for Evaluation and Diagnosis of Pleural Disease at a Tertiary Center in Canada |
| title_short | Safety and Performance Characteristics of Outpatient Medical Thoracoscopy and Indwelling Pleural Catheter Insertion for Evaluation and Diagnosis of Pleural Disease at a Tertiary Center in Canada |
| title_sort | safety and performance characteristics of outpatient medical thoracoscopy and indwelling pleural catheter insertion for evaluation and diagnosis of pleural disease at a tertiary center in canada |
| url | http://dx.doi.org/10.1155/2017/9345324 |
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