Lung India (Jan 2024)

NCCP-ICS joint consensus-based clinical practice guidelines on medical thoracoscopy

  • Rakesh K Chawla,
  • Mahendra Kumar,
  • Arun Madan,
  • Raja Dhar,
  • Richa Gupta,
  • Dipti Gothi,
  • Unnati Desai,
  • Manoj Goel,
  • Rajesh Swarankar,
  • Amita Nene,
  • Radha Munje,
  • Dhruv Chaudhary,
  • Randeep Guleria,
  • Vijay Hadda,
  • Vivek Nangia,
  • Girish Sindhwani,
  • Rajesh Chawla,
  • Naveen Dutt,
  • Yuvarajan,
  • Sonia Dalal,
  • Shailendra Nath Gaur,
  • Subodh Katiyar,
  • Jai Kumar Samaria,
  • K B Gupta,
  • Parvaiz A Koul,
  • Suryakant,
  • D J Christopher,
  • Dhrubajyoti Roy,
  • Basant Hazarika,
  • Shanti Kumar Luhadia,
  • Anand Jaiswal,
  • Karan Madan,
  • Prem Parkash Gupta,
  • B N.B.M Prashad,
  • Nasser Yusuf,
  • Prince James,
  • Amit Dhamija,
  • Veerotam Tomar,
  • Ujjwal Parakh,
  • Ajmal Khan,
  • Rakesh Garg,
  • Sheetu Singh,
  • Vinod Joshi,
  • Nikhil Sarangdhar,
  • Sushmita Roy Chaudhary,
  • Sandeep Nayar,
  • Anand Patel,
  • Mansi Gupta,
  • Rama Kant Dixit,
  • Sushil Jain,
  • Pratibha Gogia,
  • Manish Agarwal,
  • Sandeep Katiyar,
  • Aditya Chawla,
  • Hari Kishan Gonuguntala,
  • Ravi Dosi,
  • Vijya Chinnamchetty,
  • Apar Jindal,
  • Shubham Sharma,
  • Vaibhav Chachra,
  • Utsav Samaria,
  • Avinash Nair,
  • Shruti Mohan,
  • Gargi Maitra,
  • Ashish Sinha,
  • Rishabh Kochar,
  • Ajit Yadav,
  • Gaurav Choudhary,
  • M Arunachalam,
  • Amith Rangarajan,
  • Ganesh Sanjan

DOI
https://doi.org/10.4103/lungindia.lungindia_5_24
Journal volume & issue
Vol. 41, no. 2
pp. 151 – 167

Abstract

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Medical Thoracoscopy (MT) is commonly performed by respiratory physicians for diagnostic as well as therapeutic purposes. The aim of the study was to provide evidence-based information regarding all aspects of MT, both as a diagnostic tool and therapeutic aid for pulmonologists across India. The consensus-based guidelines were formulated based on a multistep process using a set of 31 questions. A systematic search of published randomized controlled clinical trials, open labelled studies, case reports and guidelines from electronic databases, like PubMed, EmBase and Cochrane, was performed. The modified grade system was used (1, 2, 3 or usual practice point) to classify the quality of available evidence. Then, a multitude of factors were taken into account, such as volume of evidence, applicability and practicality for implementation to the target population and then strength of recommendation was finalized. MT helps to improve diagnosis and patient management, with reduced risk of post procedure complications. Trainees should perform at least 20 medical thoracoscopy procedures. The diagnostic yield of both rigid and semirigid techniques is comparable. Sterile-graded talc is the ideal agent for chemical pleurodesis. The consensus statement will help pulmonologists to adopt best evidence-based practices during MT for diagnostic and therapeutic purposes.

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