What are the possible complications of a medical thoracoscopy (pleuroscopy)?

Answer

Complications of medical thoracoscopy are rare.^[17]The mortality risk is 0.09%, with a major complication rate of 1.9% and a minor complication rate of 5.6%.^[18]Complications with a rigid scope include prolonged air leak, hemorrhage, subcutaneous emphysema, postoperative fever, empyema, and seeding of chest wall from mesothelioma. Bleeding after a parietal pleural biopsy, lung perforation, and infections are the most prevalent complications about which the interventional pulmonologist is most concerned. In the case of pleurodesis, 30% of patients develop low grade fevers and may require short term hospitalization for observation.

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Media Gallery

Biopsy forceps sampling parietal pleura.
Talc pleurodesis on lung and parietal pleura.
Bulky metastasis on parietal pleura.
Examination for evidence of metastasis.
Pleural adhesions on medical thoracoscopy.
Patient positioning for medical thoracoscopy.
Trocar insertion for medical thoracoscopy.
Insertion of semirigid scope through trocar.
Olympus semirigid pleuroscope.
Olympus semirigid pleuroscope.
Olympus semirigid pleuroscope.
Semirigid pleuroscope in extension.
Semirigid pleuroscope in flexion.
Semirigid pleuroscope in neutral position.

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Author

Shannon E Burke, DO Fellow in Pulmonary and Critical Care Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, St Louis University School of Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Edward Charbek, MD, FCCP Assistant Professor of Internal Medicine, Associate Director of Pulmonary and Critical Care Fellowship Program, Division of Pulmonary, Critical Care and Sleep Medicine, St Louis University School of Medicine; Medical Director, Kindred Hospital-St Louis

Edward Charbek, MD, FCCP is a member of the following medical societies: American College of Chest Physicians, American Thoracic Society, Association of Pulmonary and Critical Care Medicine Program Directors

Disclosure: Nothing to disclose.

Chief Editor

Zab Mosenifar, MD, FACP, FCCP Geri and Richard Brawerman Chair in Pulmonary and Critical Care Medicine, Professor and Executive Vice Chairman, Department of Medicine, Medical Director, Women's Guild Lung Institute, Cedars Sinai Medical Center, University of California, Los Angeles, David Geffen School of Medicine

Zab Mosenifar, MD, FACP, FCCP is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Federation for Medical Research, American Thoracic Society

Disclosure: Nothing to disclose.

Additional Contributors

Rajiv Malhotra, DO, MS, FCCP Assistant Professor of Internal Medicine, Division of Pulmonary and Critical Care, Department of Internal Medicine, Virginia Commonwealth University; Medical Director of Cardiac Surgery ICU, Associate Fellowship Director of Interventional Pulmonology, Virginia Commonwealth University Health System

Rajiv Malhotra, DO, MS, FCCP is a member of the following medical societies: American Association for Bronchology and Interventional Pulmonology, American College of Chest Physicians, International Society for Heart and Lung Transplantation, Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Hans J Lee, MD Assistant Professor of Medicine, Director of Pleural Disease Services, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine

Hans J Lee, MD is a member of the following medical societies: American Association for Bronchology and Interventional Pulmonology, American College of Chest Physicians, American Thoracic Society, Association of Interventional Pulmonary Fellowship Directors

Disclosure: Nothing to disclose.

Ray W Shepherd, MD Associate Professor of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Virginia Commonwealth University School of Medicine; Staff Physician, Division of Pulmonary and Critical Care Medicine, Virginia Commonwealth University Medical Center

Ray W Shepherd, MD is a member of the following medical societies: American College of Chest Physicians, American Thoracic Society, Christian Medical and Dental Associations, American Association for Bronchology and Interventional Pulmonology

Disclosure: Nothing to disclose.

Cecilia C Bergh, MD Fellow in Pulmonary and Critical Care Medicine, Virginia Commonwealth University Medical Center

Disclosure: Nothing to disclose.

What are the possible complications of a medical thoracoscopy (pleuroscopy)?

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