Removal of intrapleural foreign body by medical thoracoscopy: report of two cases and a systematic review of the literature_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

GAO Ting ^1,2 , ZHAO Meng ¹ ,  YUAN Shuli ¹ , HE Xiaopeng ¹

1. Department of Respiratory and Critical Medicine, Xianyang Central Hospital, Xianyang, Shaanxi 712000, P. R. China;
2. The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P. R. China;

Corresponding author：

YUAN Shuli, Email: ysli0718@163.com

Keywords：

Thoracic cavity; foreign body; medical thoracoscopy

DOI：

10.7507/1671-6205.202210082

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Objective To explore the application of medical thoracoscopy in the extraction of intrapleural foreign bodies. Methods The clinical data of 2 cases of adult intrapleural foreign bodies were analyzed and reviewed in combination with related literatures. Results One patient with foreign body located in the right intrapleural cavity was a closed drainage tube with a broken intrapleural cavity, and the foreign body was removed with a cold trap and a thoracoscopic stab card, while in one patient, the foreign body was located in the left intrapleural cavity and was a guide wire of a single lumen central vein. Endoscopic biopsy forceps were used to remove the foreign body. Searching the literature at home and abroad, there were 8 reports of thoracoscopic removal of intrapleural foreign bodies and 9 cases. The main cause of intrapleural foreign bodies was iatrogenic improper operation, accounting for 66.7% of the total number of cases. the most common types of intrapleural foreign bodies are ruptured closed thoracic drainage tubes and puncture needles. Conclusion Medical thoracoscopy can be used to remove foreign bodies in the intrapleural cavity, which has certain application value and prospects.

Citation： GAO Ting, ZHAO Meng, YUAN Shuli, HE Xiaopeng. Removal of intrapleural foreign body by medical thoracoscopy: report of two cases and a systematic review of the literature. Chinese Journal of Respiratory and Critical Care Medicine, 2023, 22(3): 197-200. doi: 10.7507/1671-6205.202210082 Copy

1.	Sehgal IS, Dhooria S, Ram B, et al. Foreign body inhalation in the adult population: experience of 25, 998 bronchoscopies and systematic review of the literature. Respir Care, 2015, 60(10): 1438-1448.
2.	Billeter AT, Druen D, Franklin GA, et al. Video-assisted thoracoscopy as an important tool for trauma surgeons: a systematic review. Langenbecks Arch Surg, 2013, 398(4): 515-523.
3.	Agarwal R, Aggarwal AN, Gupta D. Diagnostic accuracy and safety of semirigid thoracoscopy in exudative pleural effusions: a meta-analysis. Chest, 2013, 144(6): 1857-1867.
4.	Maturu VN, Dhooria S, Bal A, et al. Role of medical thoracoscopy and closed-blind pleural biopsy in undiagnosed exudative pleural effusions: a single-center experience of 348 patients. J Bronchology Interv Pulmonol, 2015, 22(2): 121-129.
5.	陈家祥. 用纤支镜行胸腔探查取异物一例. 赣南医学院学报, 1994, 14(1): 48.
6.	殷建团, 黄申晖, 刘晓露. 胸膜腔内金属异物致脓胸合并结核性胸膜炎1例. 临床肺科杂志, 2017, 22(9): 1738-1739.
7.	谢鑫, 姜廷枢. 内科胸腔镜下取出胸腔异物一例. 中华结核和呼吸杂志, 2021, 44(3): 250-251.
8.	Tie ST, Wong JL, Kannan SK, et al. Pleuroscopic retrieval of a sewing needle from the pleural cavity under conscious sedation by a chest physician. J Bronchology Interv Pulmonol, 2012, 19(3): 246-248.
9.	Narasimhan RL, Sehgal IS, Dhooria S, et al. Removal of intrapleural foreign body by medical thoracoscopy: report of two cases and a systematic review of the literature. J Bronchology Interv Pulmonol, 2017, 24(3): 244-249.
10.	Beg MH, Reyazuddin, Ansari MM. A new role of bronchofibrescope in the removal of unusual intrapleural foreign bodies. Indian J Chest Dis Allied Sci, 1990, 32(2): 121-123.
11.	Gupta R, James P, Thangakunam B, et al. Medical thoracoscopic removal of a metal needle from the pleural space. BMJ Case Rep, 2014, 2014: bcr2014207035.
12.	Cheng WC, Wu BR, Chen CH, et al. Medical thoracoscopy removal of a self-expandable metallic stent migration into pleural cavity. J Thorac Dis, 2018, 10(5): 3054-3058.
13.	高亭, 何小鹏, 党焱, 等. 胸腔镜冷冻治疗纤维黏连为主型结核性胸腔积液的临床观察. 临床肺科杂志, 2016, 21(12): 4.
14.	高亭, 何小鹏, 党焱, 等. 内科胸腔镜胸膜活检术与血清肿瘤标志物在不明原因胸腔积液中的诊断价值. 中国内镜杂志, 2016, 22(12): 20-25.
15.	Marchetti G, Valsecchi A, Indellicati D, et al. Ultrasound-guided medical thoracoscopy in the absence of pleural effusion. Chest, 2015, 147(4): 1008-1012.
16.	Weissberg D, Weissberg-Kasav D. Foreign bodies in pleura and chest wall. Ann Thorac Surg, 2008, 86(3): 958-961.
17.	何晓峰, 史敏科, 曹彬, 等. 胸腔镜取出陈旧性肺内异物1例. 中国微创外科杂志, 2018, 18(4): 2.

1. Sehgal IS, Dhooria S, Ram B, et al. Foreign body inhalation in the adult population: experience of 25, 998 bronchoscopies and systematic review of the literature. Respir Care, 2015, 60(10): 1438-1448.
2. Billeter AT, Druen D, Franklin GA, et al. Video-assisted thoracoscopy as an important tool for trauma surgeons: a systematic review. Langenbecks Arch Surg, 2013, 398(4): 515-523.
3. Agarwal R, Aggarwal AN, Gupta D. Diagnostic accuracy and safety of semirigid thoracoscopy in exudative pleural effusions: a meta-analysis. Chest, 2013, 144(6): 1857-1867.
4. Maturu VN, Dhooria S, Bal A, et al. Role of medical thoracoscopy and closed-blind pleural biopsy in undiagnosed exudative pleural effusions: a single-center experience of 348 patients. J Bronchology Interv Pulmonol, 2015, 22(2): 121-129.
5. 陈家祥. 用纤支镜行胸腔探查取异物一例. 赣南医学院学报, 1994, 14(1): 48.
6. 殷建团, 黄申晖, 刘晓露. 胸膜腔内金属异物致脓胸合并结核性胸膜炎1例. 临床肺科杂志, 2017, 22(9): 1738-1739.
7. 谢鑫, 姜廷枢. 内科胸腔镜下取出胸腔异物一例. 中华结核和呼吸杂志, 2021, 44(3): 250-251.
8. Tie ST, Wong JL, Kannan SK, et al. Pleuroscopic retrieval of a sewing needle from the pleural cavity under conscious sedation by a chest physician. J Bronchology Interv Pulmonol, 2012, 19(3): 246-248.
9. Narasimhan RL, Sehgal IS, Dhooria S, et al. Removal of intrapleural foreign body by medical thoracoscopy: report of two cases and a systematic review of the literature. J Bronchology Interv Pulmonol, 2017, 24(3): 244-249.
10. Beg MH, Reyazuddin, Ansari MM. A new role of bronchofibrescope in the removal of unusual intrapleural foreign bodies. Indian J Chest Dis Allied Sci, 1990, 32(2): 121-123.
11. Gupta R, James P, Thangakunam B, et al. Medical thoracoscopic removal of a metal needle from the pleural space. BMJ Case Rep, 2014, 2014: bcr2014207035.
12. Cheng WC, Wu BR, Chen CH, et al. Medical thoracoscopy removal of a self-expandable metallic stent migration into pleural cavity. J Thorac Dis, 2018, 10(5): 3054-3058.
13. 高亭, 何小鹏, 党焱, 等. 胸腔镜冷冻治疗纤维黏连为主型结核性胸腔积液的临床观察. 临床肺科杂志, 2016, 21(12): 4.
14. 高亭, 何小鹏, 党焱, 等. 内科胸腔镜胸膜活检术与血清肿瘤标志物在不明原因胸腔积液中的诊断价值. 中国内镜杂志, 2016, 22(12): 20-25.
15. Marchetti G, Valsecchi A, Indellicati D, et al. Ultrasound-guided medical thoracoscopy in the absence of pleural effusion. Chest, 2015, 147(4): 1008-1012.
16. Weissberg D, Weissberg-Kasav D. Foreign bodies in pleura and chest wall. Ann Thorac Surg, 2008, 86(3): 958-961.
17. 何晓峰, 史敏科, 曹彬, 等. 胸腔镜取出陈旧性肺内异物1例. 中国微创外科杂志, 2018, 18(4): 2.

Chinese Journal of Respiratory and Critical Care Medicine

Removal of intrapleural foreign body by medical thoracoscopy: report of two cases and a systematic review of the literature

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