What is the role of a medical thoracoscopy (pleuroscopy) in the treatment of empyema and complicated parapneumonic effusions?

Updated: Jul 08, 2021
  • Author: Shannon E Burke, DO; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
  • Print
Answer

Answer

Some interventional pulmonologists have used medical thoracoscopy for drainage of uncomplicated empyema and chest tube placement. Additionally, it can be used carefully for lysis of thin fibrous adhesions. [12]

Pleural adhesions on medical thoracoscopy. Pleural adhesions on medical thoracoscopy.

Currently, this is not routinely performed or the standard of care, mainly because timing is key in these procedures and they should be considered early if chest tube drainage is inadequate. [5, 13]  In later stages of the empyema, there may be thick fibrous adhesions, pleural peel, or trapped lung. In these cases, video-assisted thoracoscopic decortication is required for treatment. [14, 15]


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!