Diagnostic accuracy and safety of semirigid thoracoscopy in exudative pleural effusions in Denmark

Fatin Willendrup, Uffe Bødtger, Sara Colella, Daniel Bech Rasmussen, Paul F Clementsen

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

BACKGROUND: To assess the diagnostic accuracy and the safety of medical thoracoscopy (MT) performed with the semirigid thoracoscope.

METHODS: We retrospectively evaluated patients who underwent MT with semirigid thoracoscope under local anesthesia for unexplained exudative pleural effusion from March 1, 2009 to September 1, 2013 in Denmark.

RESULTS: Sixty-nine patients were retrospectively studied. In 13 patients it was not possible to perform the scheduled MT, in 9 cases due to an insufficient pneumothorax, in 3 due to an insufficient pleural effusion, and in 1 due to a purulent pleuritis. In 56 patients in whom MT was completed, the procedure was diagnostic in 44 cases: malignancy was reported in 26 patients and a benign diagnosis in 18. In the remaining 12 patients a definite diagnosis was not reached, and further testing was required.In an "intention-to-treat analysis" (69 patients in total), the diagnostic accuracy of MT was 63%, the sensitivity for malignancy was 59% [95% confidence interval (CI)=43%-73%], the specificity was 100% (95% CI=86%-100%), and the negative likelihood ratio was 0.41 (95% CI=0.29-0.58). Considering the 56 patients in whom it was possible to complete the procedure, the diagnostic accuracy was 78%, the sensitivity for malignancy was 74% (95% CI=54%-87%), the specificity was 100% (95% CI=83.75%-100%), and the negative likelihood ratio was 0.27 (95% CI=0.15%-0.45%). No mortality was reported.

CONCLUSIONS: MT performed under local anesthesia with a semirigid scope is a simple and safe procedure with an acceptable sensitivity for malignancy.

Original languageEnglish
JournalJournal of Bronchology & Interventional Pulmonology
Volume21
Issue number3
Pages (from-to)215-9
Number of pages5
ISSN1944-6586
DOIs
Publication statusPublished - Jul 2014

Fingerprint

Pleural Effusion
Denmark
Safety
Confidence Intervals
Thoracoscopes
Neoplasms
Intention to Treat Analysis
Pneumothorax

Keywords

  • Pleura
  • Pleural Effusion, Malignant
  • pleura biopsy
  • Thoracoscopy
  • Diagnosis
  • Multicenter study
  • Observational comparison study
  • outpatient care

Cite this

Willendrup, Fatin ; Bødtger, Uffe ; Colella, Sara ; Bech Rasmussen, Daniel ; Clementsen, Paul F. / Diagnostic accuracy and safety of semirigid thoracoscopy in exudative pleural effusions in Denmark. In: Journal of Bronchology & Interventional Pulmonology. 2014 ; Vol. 21, No. 3. pp. 215-9.
@article{076d1d6fea9e4f14a8cc0e47b3b3fc2f,
title = "Diagnostic accuracy and safety of semirigid thoracoscopy in exudative pleural effusions in Denmark",
abstract = "BACKGROUND: To assess the diagnostic accuracy and the safety of medical thoracoscopy (MT) performed with the semirigid thoracoscope.METHODS: We retrospectively evaluated patients who underwent MT with semirigid thoracoscope under local anesthesia for unexplained exudative pleural effusion from March 1, 2009 to September 1, 2013 in Denmark.RESULTS: Sixty-nine patients were retrospectively studied. In 13 patients it was not possible to perform the scheduled MT, in 9 cases due to an insufficient pneumothorax, in 3 due to an insufficient pleural effusion, and in 1 due to a purulent pleuritis. In 56 patients in whom MT was completed, the procedure was diagnostic in 44 cases: malignancy was reported in 26 patients and a benign diagnosis in 18. In the remaining 12 patients a definite diagnosis was not reached, and further testing was required.In an {"}intention-to-treat analysis{"} (69 patients in total), the diagnostic accuracy of MT was 63{\%}, the sensitivity for malignancy was 59{\%} [95{\%} confidence interval (CI)=43{\%}-73{\%}], the specificity was 100{\%} (95{\%} CI=86{\%}-100{\%}), and the negative likelihood ratio was 0.41 (95{\%} CI=0.29-0.58). Considering the 56 patients in whom it was possible to complete the procedure, the diagnostic accuracy was 78{\%}, the sensitivity for malignancy was 74{\%} (95{\%} CI=54{\%}-87{\%}), the specificity was 100{\%} (95{\%} CI=83.75{\%}-100{\%}), and the negative likelihood ratio was 0.27 (95{\%} CI=0.15{\%}-0.45{\%}). No mortality was reported.CONCLUSIONS: MT performed under local anesthesia with a semirigid scope is a simple and safe procedure with an acceptable sensitivity for malignancy.",
keywords = "Pleura, Pleural Effusion, Malignant, pleura biopsy, Thoracoscopy, Diagnosis, Multicenter study, Observational comparison study, outpatient care",
author = "Fatin Willendrup and Uffe B{\o}dtger and Sara Colella and {Bech Rasmussen}, Daniel and Clementsen, {Paul F}",
year = "2014",
month = "7",
doi = "10.1097/LBR.0000000000000088",
language = "English",
volume = "21",
pages = "215--9",
journal = "Journal of Bronchology & Interventional Pulmonology",
issn = "1944-6586",
publisher = "Lippincott Williams & Wilkins",
number = "3",

}

Diagnostic accuracy and safety of semirigid thoracoscopy in exudative pleural effusions in Denmark. / Willendrup, Fatin; Bødtger, Uffe; Colella, Sara; Bech Rasmussen, Daniel; Clementsen, Paul F.

In: Journal of Bronchology & Interventional Pulmonology, Vol. 21, No. 3, 07.2014, p. 215-9.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Diagnostic accuracy and safety of semirigid thoracoscopy in exudative pleural effusions in Denmark

AU - Willendrup, Fatin

AU - Bødtger, Uffe

AU - Colella, Sara

AU - Bech Rasmussen, Daniel

AU - Clementsen, Paul F

PY - 2014/7

Y1 - 2014/7

N2 - BACKGROUND: To assess the diagnostic accuracy and the safety of medical thoracoscopy (MT) performed with the semirigid thoracoscope.METHODS: We retrospectively evaluated patients who underwent MT with semirigid thoracoscope under local anesthesia for unexplained exudative pleural effusion from March 1, 2009 to September 1, 2013 in Denmark.RESULTS: Sixty-nine patients were retrospectively studied. In 13 patients it was not possible to perform the scheduled MT, in 9 cases due to an insufficient pneumothorax, in 3 due to an insufficient pleural effusion, and in 1 due to a purulent pleuritis. In 56 patients in whom MT was completed, the procedure was diagnostic in 44 cases: malignancy was reported in 26 patients and a benign diagnosis in 18. In the remaining 12 patients a definite diagnosis was not reached, and further testing was required.In an "intention-to-treat analysis" (69 patients in total), the diagnostic accuracy of MT was 63%, the sensitivity for malignancy was 59% [95% confidence interval (CI)=43%-73%], the specificity was 100% (95% CI=86%-100%), and the negative likelihood ratio was 0.41 (95% CI=0.29-0.58). Considering the 56 patients in whom it was possible to complete the procedure, the diagnostic accuracy was 78%, the sensitivity for malignancy was 74% (95% CI=54%-87%), the specificity was 100% (95% CI=83.75%-100%), and the negative likelihood ratio was 0.27 (95% CI=0.15%-0.45%). No mortality was reported.CONCLUSIONS: MT performed under local anesthesia with a semirigid scope is a simple and safe procedure with an acceptable sensitivity for malignancy.

AB - BACKGROUND: To assess the diagnostic accuracy and the safety of medical thoracoscopy (MT) performed with the semirigid thoracoscope.METHODS: We retrospectively evaluated patients who underwent MT with semirigid thoracoscope under local anesthesia for unexplained exudative pleural effusion from March 1, 2009 to September 1, 2013 in Denmark.RESULTS: Sixty-nine patients were retrospectively studied. In 13 patients it was not possible to perform the scheduled MT, in 9 cases due to an insufficient pneumothorax, in 3 due to an insufficient pleural effusion, and in 1 due to a purulent pleuritis. In 56 patients in whom MT was completed, the procedure was diagnostic in 44 cases: malignancy was reported in 26 patients and a benign diagnosis in 18. In the remaining 12 patients a definite diagnosis was not reached, and further testing was required.In an "intention-to-treat analysis" (69 patients in total), the diagnostic accuracy of MT was 63%, the sensitivity for malignancy was 59% [95% confidence interval (CI)=43%-73%], the specificity was 100% (95% CI=86%-100%), and the negative likelihood ratio was 0.41 (95% CI=0.29-0.58). Considering the 56 patients in whom it was possible to complete the procedure, the diagnostic accuracy was 78%, the sensitivity for malignancy was 74% (95% CI=54%-87%), the specificity was 100% (95% CI=83.75%-100%), and the negative likelihood ratio was 0.27 (95% CI=0.15%-0.45%). No mortality was reported.CONCLUSIONS: MT performed under local anesthesia with a semirigid scope is a simple and safe procedure with an acceptable sensitivity for malignancy.

KW - Pleura

KW - Pleural Effusion, Malignant

KW - pleura biopsy

KW - Thoracoscopy

KW - Diagnosis

KW - Multicenter study

KW - Observational comparison study

KW - outpatient care

U2 - 10.1097/LBR.0000000000000088

DO - 10.1097/LBR.0000000000000088

M3 - Journal article

C2 - 24992129

VL - 21

SP - 215

EP - 219

JO - Journal of Bronchology & Interventional Pulmonology

JF - Journal of Bronchology & Interventional Pulmonology

SN - 1944-6586

IS - 3

ER -