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Kostroglou A, Kapetanakis EI, Rougeris L, Froudarakis ME, Sidiropoulou T. Review of the Physiology and Anesthetic Considerations for Pleuroscopy/Medical Thoracoscopy. Respiration 2021; 101:195-209. [PMID: 34518491 DOI: 10.1159/000518734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 07/22/2021] [Indexed: 11/19/2022] Open
Abstract
Pleuroscopy or medical thoracoscopy is the second most common utilized procedure after bronchoscopy in the promising field of interventional pulmonology. Its main application is for the diagnosis and management of benign or malignant pleural effusions. Entry into the hemithorax is associated with pain and patient discomfort, whereas concurrently, notable pathophysiologic alterations occur. Therefore, frequently procedural sedation and analgesia is needed, not only to alleviate the patient's emotional stress and discomfort by mitigating the anxiety and minimizing the pain but also for yielding better procedural conditions for the operator. The scope of this review is to present the physiologic derangements occurring in pleuroscopy and compare the various anesthetic techniques and sedative agents that are currently being used in this context.
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Affiliation(s)
- Andreas Kostroglou
- 2nd Department of Anesthesiology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Emmanouil I Kapetanakis
- Department of Thoracic Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Loizos Rougeris
- 2nd Department of Anesthesiology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Marios E Froudarakis
- Department of Respiratory Medicine, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Tatiana Sidiropoulou
- 2nd Department of Anesthesiology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Jin F, Wang H, Li Q, Li S, Lai G, Huang J, Huang Y, Jiang T, Bai C, Li S, Li W, Lu Y, Song Y, Sun R, Chen C, Zhang J, Zhang X, Zhou R, Zhou X, Chen Y, Du Y, Hu C, Zhou H. Expert consensus for diagnosis and treatment using medical thoracoscopy in China. J Thorac Dis 2020; 12:1799-1810. [PMID: 32642085 PMCID: PMC7330357 DOI: 10.21037/jtd-19-2276] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Medical thoracoscopy is a commonly used endoscopic technique for the diagnosis and treatment of respiratory diseases. As an invasive technique, it is mainly used for pleural effusions and pleural diseases that cannot be diagnosed by non-invasive methods. It is also of great application in the diagnosis and treatment of certain other diseases. Any technical operation requires special skills. There must be a learning process for mastering these skills. Although internal thoracoscopic surgery is simple, especially for respiratory specialists who have undergone training for thoracentesis or closed drainage, there are discrepancies in thoracoscopic diagnosis and treatment in hospitals in China; furthermore, the surgical methods are not uniform, and some even lead to serious complications. Therefore, the thoracoscopic diagnostic and treatment technology in China needs to be standardized. The Respiratory Professional Committee of the Integrated Medical Branch of the Chinese Medical Doctor Association invited relevant Chinese experts to formulate this standard after several rounds of discussion.
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Affiliation(s)
- Faguang Jin
- Department of Respiratory and Critical Care Medicine, Tangdu Hospital, Air Force Military Medical University, Xi'an 710038, China
| | - Hongwu Wang
- Department of Respiration, Coal General Hospital, Beijing 100028, China
| | - Qiang Li
- Department of Respiration, Shanghai General Hospital, Shanghai 200080, China
| | - Shiyue Li
- Department of Respiration, The First Affiliated College of Guangzhou Medical University, Guangzhou 510120, China
| | - Guoxiang Lai
- Department of Respiration, People's Liberation Army Fuzhou General Hospital, Fuzhou 350025, China
| | - Jianan Huang
- Department of Respiration, The First Affiliated Hospital of Suzhou University, Suzhou 215006, China
| | - Yijiang Huang
- Department of Respiration, Hainan Provincial People's Hospital, Haikou 570311, China
| | - Tao Jiang
- Department of thoracic surgery, Tangdu Hospital, Air Force Military Medical University, Xi'an 710038, China
| | - Chong Bai
- Department of Respiration, Changhai Hospital, The Second Military Medical University, Shanghai 200433, China
| | - Shengqing Li
- Department of Respiration, Huashan Hospital affiliated to Fudan University, Shanghai 200040, China
| | - Wangping Li
- Department of Respiratory and Critical Care Medicine, Tangdu Hospital, Air Force Military Medical University, Xi'an 710038, China
| | - Ye Lu
- Department of Respiration, Xiamen Third Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Xiamen 316000, China
| | - Yong Song
- Department of Respiration, Nanjing Military Region General Hospital, Nanjing 210002, China
| | - Ruilin Sun
- Department of Respiration, Guangzhou Second People's Hospital, Guangzhou 510110, China
| | - Chengshui Chen
- Department of Respiration, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Jie Zhang
- Department of Respiration, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Xiangyan Zhang
- Department of Respiration, Guizhou Provincial People's Hospital, Guiyang 550002, China
| | - Rui Zhou
- Department of Respiration, Xiangya Second Hospital, Central South University, Changsha 410008, China
| | - Xiangdong Zhou
- Department of Respiration, Southwest Military Hospital, The Third Military Medical University, Chongqing 400037, China
| | - Yanwei Chen
- Department of Respiration, Shenzhen Sixth People's Hospital, Chongqing 400038, China
| | - Yanling Du
- Department of Respiration, Yan'an University Affiliated Hospital, Yan'an 716000, China
| | - Chengping Hu
- Department of Respiration, Central South University Xiangya Hospital, Changsha 410008, China
| | - Hongmei Zhou
- Department of Respiration, Affiliated Zhongshan Hospital of Guangdong Medical University Zhongshan 524000, China
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