Respiratory Endoscopy
Online ISSN : 2758-3813
Original Article
Comparison of the Efficacy and Safety of Thoracoscopy under Local Anesthesia in Patients Aged over and under 75 Years: A Single-center Experience
Kohei FujitaZentaro SaitoTakanori ItoMakoto YodenTakuma ImakitaIssei OiRyosuke KakuYuki YamamotoOsamu KanaiHiromasa TachibanaSatoru SawaiTadashi Mio
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2024 Volume 2 Issue 1 Pages 10-17


Background: Thoracoscopy under local anesthesia is widely performed for the diagnosis of malignancies and infectious diseases. With the aging of the population, it is increasingly performed in elderly patients, but there are still few reports on its efficacy and safety. We aimed to determine whether there were any differences in the efficacy or safety of thoracoscopy under local anesthesia between elderly (75≤) and nonelderly patients (75>).

Methods: Patients who underwent thoracoscopy under local anesthesia at our hospital between January 2018 and April 2023 were reviewed retrospectively. We examined the background factors of the patients, the purpose of the examination, diseases to be examined, examination time, anesthetic methods, diagnostic and treatment success rates, and adverse events.

Results: A total of 62 patients were reviewed. Of this, 32 were elderly and 30 were nonelderly. There were more men with a history of smoking and significantly more elderly patients had hypertension.

Forty-three patients (69.4%) were treated for diagnostic purposes, 16 (25.8%) for pyothorax, 1 (1.6%) for pneumothorax, and 1 (1.6%) for diagnosis and treatment. There were no significant differences in anesthetic drugs, examination time, pathology diagnosis rate, or success rate in treating pyothorax/pneumothorax. The diagnostic rate of malignancy was 93.8%, while that of benign disease was 41.7%. There was no significant difference in the overall success rate of pathological diagnosis and treatment between elderly and nonelderly patients (78.1% vs. 93.3%, p = 0.148). Adverse events were hypoxemia, pain, and hypertension, in that order, with pain being significantly more common in the elderly, but no other significant differences as well as serious adverse events were observed.

Conclusions: The efficacy and safety of thoracoscopy under local anesthesia were similar in elderly patients as in nonelderly patients in this retrospective single-center study.

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© 2024 The Japan Society for Respiratory Endoscopy

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