Abstract
Surgical intervention is occasionally required for the treatment of pleural empyema. Semirigid thoracoscopy is a safe and successful surgical approach utilized by interventional pulmonologists, conventionally utilizing flexible forceps and suction as the main tools, but they can sometimes be inefficient for more complicated cases. In debriding a case of multiloculated empyema with semirigid thoracoscopy, we report the novel use of cryotherapy in clearing adhesions from the pleural cavity. We found using the cryoprobe to be more efficient than using forceps and suggest further investigation into its use in medical thoracoscopy.
References
1.
Roxburgh
CS
, Youngson
GG
. Childhood empyema in North-East Scotland over the past 15 years
. Scott Med J
. 2007
;52
(4
):25
–7
. .2.
Finley
C
, Clifton
J
, Fitzgerald
JM
, Yee
J
. Empyema: an increasing concern in Canada
. Can Respir J
. 2008
;15
(2
):85
–9
. .3.
Shen
KR
, Bribriesco
A
, Crabtree
T
, Denlinger
C
, Eby
J
, Eiken
P
, et al The American Association for Thoracic Surgery consensus guidelines for the management of empyema
. J Thorac Cardiovasc Surg
. 2017
;153
(6
):e129
–46
. .4.
Rahman
NM
, Maskell
NA
, West
A
, Teoh
R
, Arnold
A
, Mackinlay
C
, et al Intrapleural use of tissue plasminogen activator and DNase in pleural infection
. N Engl J Med
. 2011
;365
(6
):518
–26
. .5.
Jacobaeus
HC
. The possibilities for performing cystoscopy in examinations of serous cavities
. Münchner Med. Wschr
. 1910
;57
:2090
–2
.6.
Ravaglia
C
, Gurioli
C
, Tomassetti
S
, Casoni
GL
, Romagnoli
M
, Gurioli
C
, et al Is medical thoracoscopy efficient in the management of multiloculated and organized thoracic empyema?
Respiration
. 2012
;84
(3
):219
–24
. .7.
Neel
HB
, Farrell
KH
, Desanto
LW
, Payne
WS
, Sanderson
DR
. Cryosurgery of respiratory structures. I. cryonecrosis of trachea and bronchus
. Laryngoscope
. 1973
;83
(7
):1062
–71
. .8.
Rozman
A
, Camlek
L
, Marc Malovrh
M
, Kern
I
, Schönfeld
N
. Feasibility and safety of parietal pleural cryobiopsy during semi-rigid thoracoscopy
. Clin Respir J
. 2016
;10
(5
):574
–8
. .9.
Wurps
H
, Schönfeld
N
, Bauer
TT
, Bock
M
, Duve
C
, Sauer
R
, et al Intra-patient comparison of parietal pleural biopsies by rigid forceps, flexible forceps and cryoprobe obtained during medical thoracoscopy: a prospective series of 80 cases with pleural effusion
. BMC Pulm Med
. 2016
;16
(1
):98
. .10.
Tousheed
SZ
, Manjunath
PH
, Chandrasekar
S
, Murali Mohan
BV
, Kumar
H
, Hibare
KR
, et al Cryobiopsy of the pleura: an improved diagnostic tool
. J Bronchology Interv Pulmonol
. 2018
;25
(1
):37
–41
..11.
Yap
KH
, Phillips
MJ
, Lee
YC
. Medical thoracoscopy: rigid thoracoscopy or flexi-rigid pleuroscopy?
Curr Opin Pulm Med
. 2014
;20
(4
):358
–65
. .12.
Dhooria
S
, Bal
A
, Sehgal
IS
, Prasad
KT
, Muthu
V
, Aggarwal
AN
, et al Pleural cryobiopsy versus flexible forceps biopsy in subjects with undiagnosed exudative pleural effusions undergoing semirigid thoracoscopy: a Crossover Randomized Trial (COFFEE Trial)
. Respiration
. 2019
;98
(2
):133
–41
. .© 2020 S. Karger AG, Basel
2020
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