Medical Thoracoscopy is used to observe the pleura and take biopsies from abnormal areas. Sometimes it is used to break adhesions and treat septated pleural effusions. Medical Thoracoscopy performed by Best Thoracoscopy Expert Doctor in India.
Assessment is done prior to Medical Thoracoscopy
A diagnostic pleural tap is always done prior to the procedure. An exudative fluid indicates the need for thoracoscopy. A CT scan preferable to a contrast CT scan is necessary prior to the procedure. This helps in assessing the pleura and the lung parenchyma beneath the fluid. A blood test which includes complete blood count, serum creatinine level, bleeding profile, and viral markers are also done. COVID-19 PCR should be done prior to the procedure depending on the prevalence of the infection in the area. Blood thinners need to be stopped 5 days prior to the test.
Things to remember on the day of the procedure
Fasting of 6 hours for solid food and 4 hours for clear liquids is recommended. The routine medications should be continued for blood pressure. Diabetic patients should avoid their Insulin and hypoglycemic medicines on the day of the test.
The procedure is performed through a nick in the chest wall. You may get some intravenous (IV) injections prior to and during the procedure for sedation. After local anesthesia at the site of nick, the scope is inserted. The pleura is observed and biopsies are taken. In the case of adhesions, they are broken with adhesiolysis forceps and the scope. After the scope is removed, a chest tube is left in place to drain the fluid. The procedure usually takes 30-40 minutes.
Precautions after the procedure
The patient has to avoid any oral liquids or solids for another 2 hours after the procedure. A light meal is recommended after 2 hours. The chest tube would remain in the chest till the fluid stops coming, usually a couple of days (in case of malignant effusions, the duration may be longer). The common after-effects of the procedure are – pain at the site, soakage of dressing with fluid, sleepiness, and vomiting. These can be managed with symptomatic medicines. Usually, a patient is kept admitted for a day or two post-procedure. In special cases, the patient may be sent home after the procedure.
Medical thoracoscopy is a safe procedure and does not have any long-term complications. Once the chest tube is out and the diagnosis is clinched, the optimal treatment would be started. The microbiology and pathology reports come in 3-5 days’ periods. If mycobacterial cultures are applied they usually take 4 weeks. Medical thoracoscopy is a safe procedure with a minimal complication rate.