| Title: |
Safety and Diagnostic Yield of Medical Pleuroscopy (MP) Performed under Balanced Analgosedation by a Pneumological Team Compared to Video-Assisted Thoracic Surgery (VATS): A Retrospective Controlled Real-Life Study (TORAPO) |
| Authors: |
Allocca V.; Guidelli L.; Galgano A.; Benedetti L.; Fabbroni R.; Bianco A.; Paladini P.; Scala R. |
| Contributors: |
Allocca, V.; Guidelli, L.; Galgano, A.; Benedetti, L.; Fabbroni, R.; Bianco, A.; Paladini, P.; Scala, R. |
| Publication Year: |
2024 |
| Collection: |
Università degli Studi di Siena: USiena air |
| Subject Terms: |
analgosedation; diagnostic yield; medical pleuroscopy; propofol; pulmonologist; toracoscopy |
| Description: |
Introduction: Medical pleuroscopy (MP) is an invasive technique that provides access to the pleural space with a rigid or semi-rigid work instrument, allowing for visualization and the obtaining of bioptic pleural samples. Using pulmonologist-based analgosedation to perform pleuroscopy is still debated for safety reasons. The aim of this real-life study is to demonstrate the safety and diagnostic yield of MP performed under balanced analgosedation by a pulmonologist team with expertise in the management of critically ill patients in the respiratory intensive care unit (RICU) and interventional pulmonology unit as compared to video-assisted thoracic surgery (VATS) performed by a thoracic surgeon team under anesthesiologist-based analgosedation. Methods: In this multicentric retrospective controlled study, the inclusion criteria were patients older than 18 years old with pleural effusion of unknown diagnosis consecutively admitted in the years 2017–2022 to the pulmonology unit and RICU of San Donato Hospital in Arezzo (Italy, Tuscany) and to the thoracic surgery unit of Santa Maria Le Scotte in Siena (Italy, Tuscany) to undergo, respectively, MP under balanced propofol-based analgosedation on spontaneous breathing with local anesthesia provided by a pulmonologist team (Group A), and VATS provided by a surgeon team under propofol-based analgosedation managed by an anesthesiologist using invasive mechanical ventilation (IMV) via endotracheal intubation (ETI) (Group B). The primary endpoints were (1) a comparison between the two groups in terms of the diagnostic yield of pleural effusion, and (2) major and minor complications of pleuroscopic procedures. The secondary endpoints were (1) the length of the pleuroscopic procedure; (2) the duration of hospitalization; (3) propofol doses; and (4) the patient’s comfort after the procedure assessed using the Visual Analogue Scale (VAS). Results: We enrolled 91 patients in Group A and 116 patients in Group B. A conclusive diagnosis was obtained in 97.8% of Group A vs. 100% of ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
ELETTRONICO |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/38534990; info:eu-repo/semantics/altIdentifier/wos/WOS:001191918500001; volume:14; issue:6; numberofpages:14; journal:DIAGNOSTICS; https://hdl.handle.net/11365/1276844; https://pmc.ncbi.nlm.nih.gov/articles/PMC10969653/ |
| DOI: |
10.3390/diagnostics14060569 |
| Availability: |
https://hdl.handle.net/11365/1276844; https://doi.org/10.3390/diagnostics14060569; https://www.mdpi.com/2075-4418/14/6/569; https://pmc.ncbi.nlm.nih.gov/articles/PMC10969653/ |
| Rights: |
info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.2189837B |
| Database: |
BASE |