Journal Club December 2022

Control of bleeding from intercostal artery laceration. 

Sabath BF, et al.

Respir Med Case Rep.

PMID: 36440304 

A case report and management approach for the uncommon (less than 1% of procedures) but important complication of bleeding at thoracoscopy. The authors provide a review of the literature and a video of successful control of bleeding using extra-thoracic pressure.

Impact of a Pleural Care Program on the Management of Patients With Malignant Pleural Effusions. 

Alwakeel AJ, et al.

J Bronchology Interv Pulmonol.

PMID: 36476591

A before and after intervention study from a Saudi group who had initiated a pleural care program in their hospital for those with malignant effusions. Outcomes such as hospitalisation, chest tube insertion and time to definitive procedures all fell following initiation. Useful data for a business case if needed.

Duration of antimicrobial therapy after video-assisted thoracoscopic surgery for thoracic empyema and complicated parapneumonic effusion: A single-center study. 

Yukumi S, et al.

Respir Investig.

PMID: 36470803

There is significant variation in the duration of therapy recommended for pleural infection. Within this single centre cohort study of patients with Stage 3 or 4 pleural infection who had VATS the duration of antibiotics seven days. Which seems on the short side except the patients had waited on average 13 days for their procedure.

Sensitivity and complications of thoracentesis and thoracoscopy: a meta-analysis. 

Martinez-Zayas G, et al.

Eur Respir Rev.

PMID: 36543349  A comprehensive systematic review and meta-analysis of thoracentesis and thoracoscopy outcomes split by cancer type. Findings for thoracentesis demonstrated that the pooled sensitivity was 64% (mesothelioma worst to breast cancer best). The sensitivity of thoracoscopy was 93% overall (92% for MPM). Slightly surprisingly the complication rates for thoracoscopy and thoracentesis were identical