Thoracoscopy: a useful tool in the diagnosis of thoracic disease

Our plain-English summary of Thoracoscopy: a useful tool in the diagnosis of thoracic disease, by J.I. Miller, C.R. Hatcher (The Annals of Thoracic Surgery, 1978).

The study

• Authors: J.I. Miller, C.R. Hatcher
• Journal: The Annals of Thoracic Surgery
• Published: 1978;26(1):68-72
• Type of article: Case report
• Cited by: 34 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

During a 12-month period, 11 patients underwent diagnostic thoracoscopy for previously undiagnosed thoracic disease. In all patients, the diagnosis had been unobtainable by the usual diagnostic modalities of bronchoscopy, scalene node biopsy, mediastinoscopy, thoracentesis, or closed pleural biopsy. Thoracoscopy was diagnostic in 10 of the 11 patients. There was no morbidity or mortality. In all patients the indication for thoracoscopy was suspected malignancy. The majority of patients had recurrent pleural effusions in which routine cytological studies and tissue biopsies had been nondiagnostic. Pathological findings were mesothelioma in 3 patients, primary carcinoma of the lung in 4, congestive heart failure with pleural effusion in 1, metastatic carcinoma in 2, and inflammatory disease in 1 patient. Indications, techniques, and results are discussed. Thoracoscopy is a valuable tool in the diagnosis of thoracic disease; with it, unneccessary thoracotomy can often be avoided.

In plain English

This article reported on 11 patients at Emory University Affiliated Hospitals in Atlanta who had diagnostic thoracoscopy between July 1, 1976, and July 1, 1977. Thoracoscopy means looking inside the chest through a small cut with a viewing instrument. The patients were 4 women and 7 men aged 54 to 74. They had recurrent pleural effusions (fluid around the lungs) or suspected pleural disease that bronchoscopy, thoracentesis, closed pleural biopsy or mediastinoscopy had not diagnosed. The article did not report any asbestos exposure for these patients. Thoracoscopy gave a diagnosis in 10 of the 11 patients, and there was no morbidity or mortality. No patient needed thoracotomy (open chest surgery). The findings were mesothelioma in 3 patients, primary lung carcinoma in 4, metastatic carcinoma in 2, congestive heart failure in 1 and inflammatory disease in 1. In one case report, a 55-year-old man's chest X-ray showed pleural plaquing, and biopsies showed mesothelioma involving the pleura, pericardium and diaphragm. The authors concluded that thoracoscopy can generally make the diagnosis and avoid unnecessary diagnostic thoracotomy.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case series: a report of one hospital service's experience with 11 patients, with representative case reports
• Who was studied: 11 patients (4 women, 7 men, aged 54 to 74) with previously undiagnosed thoracic disease, treated at Emory University Affiliated Hospitals, Atlanta, from July 1, 1976, to July 1, 1977
• Main results:
  • Thoracoscopy was diagnostic in 10 of the 11 patients
  • There was no morbidity or mortality, and no patient required thoracotomy
  • Pathological findings: mesothelioma in 3 patients, primary carcinoma of the lung in 4, congestive heart failure in 1, metastatic carcinoma in 2, inflammatory disease in 1
  • Overall, 9 patients had a malignant process and 2 had benign disease
  • Patient 1, a 55-year-old man, had a chest X-ray showing a left lower lobe nodule and pleural plaquing; thoracoscopic biopsies showed mesothelioma involving the visceral and parietal pleura, pericardium and diaphragm
• The authors' conclusion: The authors concluded that with diagnostic thoracoscopy the diagnosis can generally be made with adequate tissue biopsy, and unnecessary diagnostic thoracotomy can be avoided

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer.

Medical terms in this study, explained in our Lexicon: Thoracoscopy, Bronchoscopy, Biopsy, Mediastinoscopy, Thoracentesis, Pleural Biopsy, Pleural Effusion, Mesothelioma.

Related studies

• Taking a retrospective look at asbestos-related thoracic disease produces interesting results — E.B. Gottschall (2010)
• Notes from the 2012 Annual Meeting of the Korean Society of Thoracic Radiology: asbestos-related thoracic diseases — J.S. Kim, J.G. Yi, et al. (2013)
• Medical thoracoscopy vs CT scan-guided Abrams pleural needle biopsy for diagnosis of patients with pleural effusions: a randomized, controlled trial — M. Metintas, G. Ak, et al. (2010)
• Thoracoscopy in the early diagnosis of malignant pleural effusions — C. Boutin, P. Cargnino, et al. (1980)
• Medical thoracoscopy in the diagnosis of unexplained pleural effusion — M.L. Wilsher, A.G. Veale (1998)
• An electrocautery pleural biopsy for the diagnosis of desmoplastic malignant mesothelioma during semirigid thoracoscopy — S. Sasada, K. Kawahara, et al. (2008)

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