Abstract
In order to improve the safety measures for thoracoscopy under local anesthesia, we studied the accomplishment rate of and complications due to thoracoscopy and examined the measure to be taken. Method. In all the cases in which thoracoscopy under local anesthesia was scheduled to be performed at our endoscopy room during the period from April 2000 to November 2005, we examined the schedule change, complications associated with thoracoscopy, and early death within one month after thoracoscopy. Results. Thoracoscopy was scheduled in 158 cases. Among them, 7 cases canceled thoracoscopy due to the difficulty in thoracic port placement and 151 cases underwent thoracoscopy under local anesthesia. Two of the 151 cases did not undergo pleural biopsy due to the difficulty in intrathoracic procedures. The schedule change was attributable to reduction of pleural effusion during thoracoscopy, severe thickening of the parietal pleura, and adhesive changes. Though the injury of visceral pleura, among complications associated with thoracoscopy, was caused by damaging the thickened visceral pleura during port insertion, the case was only carefully observed without treatment because there was no bleeding or air leak during and after thoracoscopy. Other complications included 1 case in which drain reinsertion was required due to the occurrence of subcutaneous emphysema, and 1 case each of subcutaneous infection and empyema after thoracoscopy. Both of the 2 early postoperative death cases were carcinomatous pleurisy, and diagnosed as death from the progression of the primary disease 12 and 28 days after thoracoscopy respectively. Accomplishment rate of intrathoracic observation and pleural biopsy was 94.3%, and the rate of complications that require treatment was 2.0%. The diagnosis of pleurisy using thin thoracic videoscope at endoscopy room showed a high accomplishment rate, which we believe demonstrated an acceptable level of safety. (JJSRE. 2006;28:582-584)
