CHEST Guidelines-Provision-of-Day-Case-Local-Anesthetic-Thoracoscop

Provision-of-Day-Case-Local-Anesthetic-Thoracoscop

Pdf Summary

The provided document highlights a study evaluating the effectiveness and safety of day-case Local Anesthetic Thoracoscopy (LAT) for pleural disease diagnosis across five centers—four in the UK and one in the US. Pleural disease affects around 3,000 per million people, with pleural effusion being the most common condition requiring diagnosis. While generally identified through non-invasive methods, 25% of cases need further invasive procedures like LAT. This retrospective study used data from January 2010 to January 2015 to analyze 521 LAT procedures, excluding 19 due to missing data. Of the 502 analyzable cases, 242 were designated as day-case LAT, with 202 completed successfully on the same day, and 97% provided a definitive diagnosis. Only a few complications were reported, demonstrating the procedure's safety. LAT was abandoned in 16.5% of day-case attempts, mainly due to factors like equipment failure or lack of pneumothorax induction. The study's findings support that LAT can be used as a convenient, safe, and effective day-case procedure, suggesting its potential role in early diagnostic pathways for pleural diseases. In addition to providing diagnostic accuracy, this approach negates the need for hospital admission for most patients, offering a viable alternative to the traditional inpatient approach. The research article also briefly mentions developments in cryobiopsy for interstitial lung disease, noting its potential for cost savings and procedural improvements in comparison to surgical lung biopsies. The document emphasizes cryobiopsy's advancements in efficiency, reduced procedure times, and decreased complications, likening it to LAT's innovations in pleural disease management. Overall, the study suggests improved patient outcomes and healthcare resource usage through innovative, less invasive approaches in thoracic medicine.

Keywords

Local Anesthetic Thoracoscopy

LAT

pleural disease

day-case procedure

diagnostic accuracy

cryobiopsy

interstitial lung disease

retrospective study

thoracic medicine

healthcare resource usage