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Canadian Respiratory Journal
Volume 2017 (2017), Article ID 9345324, 6 pages
https://doi.org/10.1155/2017/9345324
Research Article

Safety and Performance Characteristics of Outpatient Medical Thoracoscopy and Indwelling Pleural Catheter Insertion for Evaluation and Diagnosis of Pleural Disease at a Tertiary Center in Canada

1Department of Medicine, Division of Respirology, University of British Columbia, Vancouver, BC, Canada
2Department of Medicine, Division of Respirology, University of Alberta, Edmonton, AB, Canada
3Department of Medicine, Division of Respirology, University of Ottawa, Ottawa, ON, Canada
4Department of Radiology, University of Ottawa, Ottawa, ON, Canada

Correspondence should be addressed to Kayvan Amjadi

Received 10 May 2017; Revised 18 July 2017; Accepted 31 July 2017; Published 30 August 2017

Academic Editor: Jack Kastelik

Copyright © 2017 Robert Kyskan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Many centers performing medical thoracoscopy (MT) to diagnose pleural disease will insert a chest tube and admit patients to hospital after the procedure, which is inconvenient for patients and contributes to healthcare costs. We report the data on the safety, outcomes, and performance characteristics of outpatient MT with indwelling pleural catheter (IPC) insertion in a large Canadian cohort. Methods. This retrospective cohort study reviewed patients who underwent outpatient MT and IPC insertion under conscious sedation. Patients without complications were discharged the same day. We report the data on safety, outcomes, and performance characteristics of our program. Results. Outpatient MT and IPC insertion was performed on 218 patients. 99.1% of patients were safely discharged the same day. There was no procedure associated mortality. Pleural malignancy (59.6%) and nonspecific pleuritis (29.4%) were the most common pathologies. Pleural nodularity detected endoscopically was excellent at predicting malignancy with a positive predictive value of 92.5% and is more frequently detected endoscopically when compared to CT scan (). Conclusions. In the setting of a comprehensive pleural disease program, outpatient MT can be safely performed and is an alternative to an inpatient surgical approach for undiagnosed pleural effusions.