The role of day-case thoracoscopy at a district general hospital: A real world observational study
Abstract
Objective
To assess the feasibility and safety of talc pleurodesis performed as part of day-case medical thoracoscopy.
Methods
A Richard Wolf® 5 mm mini thoracoscope through a 5.5 mm port was used with eligible cases having talc poudrage followed by insertion of indwelling pleural catheter (IPC). District nurses drain the IPC daily for the first 5 days. Once the drain output is <150 mL, the frequency is progressively reduced to once weekly. The drain is removed after two consecutive dry taps 1 week apart.
Results
Overall, 51 patients underwent day-case thoracoscopy. Median time to removal of IPC for our day-case protocol was 14 days. There were seven deaths within 70 days among 41 patients with malignant pleural effusion in the day-case cohort, compared to eight deaths in the 33 conventional thoracoscopy controls. Overall, the day-case cohort observed a statistically significant reduction in all-cause mortality at 180 days compared to the conventional cohort (log rank p = 0.024). The average cost per patient of the day-case and inpatient cohort was £1,328.0 ± 106.0 and £1,835.0 ± 295.0 (p = 0.961).
Conclusion
This study suggests that thoracoscopy and talc poudrage can be performed safely as a day-case procedure. Further data are needed to ascertain long-term outcomes.
Citations
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Date
2024-09
Type
Article
Subject
Pulmonary Medicine, Catheters, Indwelling, Day Care, Medical
Collections
Citation
Kiran, S., Mavilakandy, A., Rahim, S., Naeem, M., Rawson, S., Reed, D., Tsaknis, G., & Reddy, R. V. (2024). The role of day-case thoracoscopy at a district general hospital: A real world observational study. Future healthcare journal v11(3) article: 100158. https://doi.org/10.1016/j.fhj.2024.100158