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Fantin A, Castaldo N, Palou MS, Viterale G, Crisafulli E, Sartori G, Patrucco F, Vailati P, Morana G, Mei F, Zuccatosta L, Patruno V. Beyond diagnosis: a narrative review of the evolving therapeutic role of medical thoracoscopy in the management of pleural diseases. J Thorac Dis 2024; 16:2177-2195. [PMID: 38617786 PMCID: PMC11009601 DOI: 10.21037/jtd-23-1745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/02/2024] [Indexed: 04/16/2024]
Abstract
Background and Objective Medical thoracoscopy (MT) is an endoscopic technique performed by interventional pulmonologists with a favorable safety profile and few contraindications, providing diagnostic and therapeutic intervention in a single sitting. This narrative review was designed to summarize the therapeutic role of MT based on the latest results from the available literature. Methods Pertinent literature published in English, relative to human studies, between 2010-2022 was searched in Medline/PubMed and Cochrane databases. Publications regarded as relevant were considered for inclusion in this review; additional references were added based on the authors' knowledge and judgment. The review considered population studies, meta-analyses, case series, and case reports. Key Content and Findings MT has mostly been described and is currently used globally in the diagnostic approach to exudative pleural effusion of undetermined origin. Carefully evaluating the literature, it is clear that there is initial evidence to support the use of MT in the therapeutic approach of malignant pleural effusion, pneumothorax, empyema, and less frequently hemothorax and foreign body retrieval. Conclusions MT is an effective procedure for treating the clinical entities presented in this document; it must be carried out in selected patients, managed in centers with high procedural expertise. Further evidence is needed to assess the optimal indications and appropriate patients' profiles for therapeutic MT. The endpoints of length of hospital stay, surgical referral, complications and mortality will have to be considered in future studies to validate it as a therapeutic intervention to be applied globally.
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Affiliation(s)
- Alberto Fantin
- Department of Pulmonology, S. Maria della Misericordia University Hospital, Udine, Italy
| | - Nadia Castaldo
- Department of Pulmonology, S. Maria della Misericordia University Hospital, Udine, Italy
| | - Michelangelo Schwartzbaum Palou
- Department of Medicine, Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Giovanni Viterale
- Department of Medicine, Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Ernesto Crisafulli
- Department of Medicine, Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Giulia Sartori
- Department of Medicine, Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Filippo Patrucco
- Respiratory Diseases Unit, Medical Department, AOU Maggiore della Carità di Novara, Novara, Italy
- Translational Medicine Department, University of Eastern Piedmont, Novara, Italy
| | - Paolo Vailati
- Department of Pulmonology, S. Maria della Misericordia University Hospital, Udine, Italy
| | - Giuseppe Morana
- Department of Pulmonology, S. Maria della Misericordia University Hospital, Udine, Italy
| | - Federico Mei
- Pulmonary Diseases Unit, Azienda Ospedaliero Universitaria delle Marche, Ancona, Italy
| | - Lina Zuccatosta
- Pulmonary Diseases Unit, Azienda Ospedaliero Universitaria delle Marche, Ancona, Italy
| | - Vincenzo Patruno
- Department of Pulmonology, S. Maria della Misericordia University Hospital, Udine, Italy
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Kakamad FH, Ali RK, Amin BJH, Mohammed SH, Omar DA, Mohammed KK, Karim SO, Kakamad SH, Salih RQM, Mohammed DA, Salih AM, Mustafa MQ. The role of VATS in the removal of intrathoracic foreign bodies - a systematic review. Indian J Thorac Cardiovasc Surg 2023; 39:125-136. [PMID: 36785615 PMCID: PMC9918628 DOI: 10.1007/s12055-022-01445-9] [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: 05/12/2022] [Revised: 11/12/2022] [Accepted: 11/16/2022] [Indexed: 12/28/2022] Open
Abstract
Introduction To date, no systematic review or meta-analysis study has been conducted regarding the use of video-assisted thoracoscopic surgery (VATS) in the removal of intrathoracic foreign bodies (FB). This systematic review aims to evaluate the feasibility of VATS in the removal of intrathoracic FBs. Methods PubMed/MEDLINE, CINAHL, Web of Science, EMBASE, and Cochrane Library databases were systematically searched to identify reports published up to April 1, 2022. Results The initial systematic search revealed a total of 208 papers, of which only 54 studies reporting 71 cases were included in this systematic review. Among the patients, 46 (64.8%) were male, 22 (31%) were female, and 3 (4.2%) were unknown. The mean age was 34.5 ± 24.3 years (1 day to 98 years). The patients were of 3 etiologic groups: iatrogenic (31, 43.7%), traumatic (28, 39.4%), and accidental (9, 12.7%). Most of the patients were emergency cases (27, 38%). The most frequently used imaging modalities to diagnose these foreign bodies were X-ray (46, 64.8%), followed by computed tomography (44, 62%), and ultrasonography (16, 22.5%). About 43% of all the foreign bodies were therapeutic equipment. The pleural cavity had the highest involvement (36.8%), followed by the lung parenchyma (14.6%) and thoracic cavity (13.2%). Regardless of the number of access ports, all the patients had a good clinical outcome. Conclusion VATS is a safe and effective method for the removal of intrathoracic FBs from various thoracic sites that are associated with a good clinical outcome - in both elective and emergency cases.
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Affiliation(s)
- Fahmi Hussein Kakamad
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan Iraq
- Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan Iraq
- College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan Iraq
| | | | - Bnar Jamal Hama Amin
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan Iraq
- Shar Hospital, Sulaimani, Kurdistan Iraq
| | - Shvan Hussein Mohammed
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan Iraq
- Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan Iraq
| | - Diyar Adnan Omar
- Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan Iraq
- Medical Laboratory Technology, Shaqlawa Technical College, Erbil Polytechnic University, Erbil, Iraq
| | - Karukh Khalid Mohammed
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan Iraq
- Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan Iraq
| | - Sanaa Othman Karim
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan Iraq
- College of Nursing, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan Iraq
| | | | - Rawezh Qadir Mohammed Salih
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan Iraq
- Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan Iraq
| | | | - Abdulwahid Mohammed Salih
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan Iraq
- College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan Iraq
| | - Mohammed Qader Mustafa
- Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan Iraq
- Department of Medical Analysis, Tishk International University – Erbil, Kurdistan Region, Erbil, Iraq
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Chiappetta M, Sassorossi C, Lococo F, Lorusso R, Nachira D, Margaritora S. Intrapleural Foreign Body in a Critically Ill Patient. Chest 2022; 161:e51-e53. [DOI: 10.1016/j.chest.2021.04.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 03/25/2021] [Accepted: 04/24/2021] [Indexed: 11/24/2022] Open
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