Chest tube drainage of phase Il Empyema is a way of treatment in some patients but thoracostomy is - needed in some situations. Thoracoscopic inte11Jentionis a new approach for above mentioned patients with low mortality and morbidity, although it is obvious that the chest tube drainage for phase one Empyema and thoracostomy for phase III is strictly indicated. Twenty patients with average age of 40 (18-60) were undergone thoracostomy and Thirty patients with average age of 48 (20-65) thoracoscopic intervention with phase II Empyema. Post operation complication was more in 1st group that was performed thoracostomy.Post-operation bleeding in one case, airleakage in are and wound infection in three patients were obse11Jedin group I, but in 2nd group only one post-op bleeding and one Airleakage were seen.There was no difference in operation lime, but difference was obvious in hospital stay (11 versus 6 duys). Therefore the THORACOSCOPY is recommended as a choice treatment for phase II Empyema Because of low post operation complications, hospital stay, pain and cosmetic reasons.

Background: One of the most common indications for pleuroscopy is undiagnosed pleural effusion, which comprises about 25% of all cases of pleural effusions, which remain undiagnosed despite primary tests. Pleuroscopy was performed for the first time in Iran in Masih Daneshvari hospital located in Tehran. The aim of this study was to assess the diagnostic yield of pleuroscopy performed in this center in Iran.Materials and Methods: Three-hundred patients with undiagnosed pleural effusions were enrolled in this study. For all patients, primary tests including pleural effusion analysis, cytology and closed pleural biopsy (if needed) were conducted and all of them were inconclusive. The semirigid THORACOSCOPY (pleuroscopy) was performed for all patients for diagnostic purposes.Results: Eighty-seven percent of the peluroscopies were diagnostic and 67% of them were diagnosed as malignancy while the rest were diagnosed as tuberculosis. Only 11 patients developed minor complications.Conclusion: In conclusion, pleuroscopy is a safe procedure when performed by a skilled and experienced practitioner, it has a high diagnostic yield and results in only minor complications.

Background and Aims: Better clinical outcomes are observed in patients who undergo thoracic procedures under thoracic epidural anesthesia (TEA). This study aimed to compare the outcome of diagnostic THORACOSCOPY between patients with General anaesthesia (GA) and TEA.Materials and Methods: In this randomized prospective study 30 candidates of diagnostic THORACOSCOPY underwent either GA (n=15) or TEA (m=15). Pre-, intra-, and post-operational vital signs and O2 saturation, pre- and post-operational parameters of arterial blood gas (ABG), and post-operational pain, need of analgesics, complications, hospital stay and mortality rate were documented and compared between two groups.Results: Vital signs and ABG parameters were comparable between the two groups. Although there was better condition in the TEA group, the mean post-operational pain, dose of analgesics and hospital stay were comparable between the two groups statistically. There was no case with intra-operational agitation, change to general anesthesia, complications, need for intensive care unit admission, or mortality.Conclusion: In candidates of diagnostic THORACOSCOPY, TEA is at least equal to GA in terms of intraoperational vital signs and parameters of ABG. TEA is superior to GA regarding post-operative pain and hospital stay, but this predominance does not reach a statistically significant level.

Introduction: Various strategies could be considered dealing with penetrating thoracic injuries. THORACOSCOPY is much less invasive than routine thoracotomy approach for managing such cases in which the sharp object remains in the body. The case presented in this article was managed with THORACOSCOPY for a penetrating dorsolateral thoracic injury. Case Presentation: A 35-year-old man with a penetrating dorsolateral thoracic injury referred to the emergency department. Despite an elevated pulse rate, the patient has proper blood pressure and O2 saturation. Considering the patient's stability and the results of imaging which did not show any massive vascular injury, the patient was taken to the operation room for THORACOSCOPY. At THORACOSCOPY, we saw 4 cm of the blade in the thoracic cavity between the third and fourth intercostal space. There was a mild laceration of lung tissue without any active bleeding. Considering the position of the blade and the absence of active bleeding and vascular injury at the trauma site, we successfully removed the blade by the thoracoscope without any complications. Conclusion: Our experience of removing a retained knife by THORACOSCOPY showed that it can be an appropriate alternative for patients with penetrating thoracic injury who are hemodynamically stable and have appropriate conditions for THORACOSCOPY.