Overview of Medical Thoracoscopy in Peripheral Lung Lesions and Undiagnosed Pleural Effusion

Medical thoracoscopy is typically performed for diagnostic purposes particularly in the case of pleural effusions and for talc pleurodesis to stop the recurrence of pneumothorax or chronic pleural effusions.Thoracoscopy and video-assisted thoracoscopic surgery (VATS) are two techniques that can be used in the evaluation of undiagnosed exudative pleural effusions.The incidence of peripheral pulmonary lesions (PPLs) in the general population is unknown. Lung cancer computed tomographic (CT) screening studies of smokers at high risk for malignancy report a prevalence of nodules as high as 50 percent, with other CT studies in the general population reporting a prevalence of incidental nodules at 31%. The focus of the clinical evaluation is to determine the presence of risk factors for malignancy and to evaluate the presence of non-malignant conditions that are associated with solitary pulmonary nodule (SPN). When symptoms are present, they usually reflect the underlying condition that resulted in the development of the lung nodule. In the setting of malignancy, the presence of symptoms may represent advanced metastatic disease. Risk factors such as smoking, advanced age, prior history of malignancy, interstitial lung disease, emphysema, and exposure to asbestos, uranium, and radon are associated with a higher chance of a malignant SPN. A few deaths associated to thoracoscopy itself have been reported in the literature,but we have to be aware that fatal complications can occur. When talc poudrage is added to the procedure, the rate of complications is expected to rise, especially in patients with poor general condition prior to thoracoscopy.In order to understand better how to manage complications, it is convenient to separate them in several categories.Therefore, this study aimed to overview the diagnostic utility of medical thoracoscopy in peripheral lung lesions and undiagnosed pleural effusion