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��Medical�� thoracoscopy can be performed by physicians under conscious sedation with local anaesthetic in an endoscopy suite, and as a result is less invasive and less expensive (4). Its popularity has varied in the past, but has enjoyed renewed interest from pulmonary physicians in the United Kingdom, Europe and United States over the recent years (5�C7). Medical thoracoscopy is primarily considered a diagnostic procedure for exudative pleural effusion (3, 8), and often there is symptom management with drainage of the effusion and possibly talc pleurodesis (4). For the diagnosis of malignant pleural disease, medical thoracoscopy has consistently been demonstrated to be superior to fluid cytology and ��blind�� closed needle biopsy (9�C11) with a sensitivity of up to 95% (12). A recent study comparing medical thoracoscopy http://www.selleckchem.com/products/ABT-263.html with computerised tomography (CT)-guided Abrams needle biopsy demonstrated no significant difference with the two techniques (13), although the advantage of thoracoscopy remains that a concurrent pleurodesis after pleural fluid removal can be performed. Thoracoscopy can also be used for the investigation and treatment of primary spontaneous pneumothorax and management http://www.selleckchem.com/products/abt-199.html of empyema (14, 15), although its use for these indications is less widespread. Thoracoscopy in the hands of experienced physicians is safe with large series reporting mortality rates of http://www.selleck.cn/products/CP-690550.html countries have used graded large particle talc, which has now proven safety and efficacy in poudrage for malignant pleural effusions (22). In our institution respiratory physicians have been performing medical thoracoscopy for over 19 years. This large district general hospital serves the city of Portsmouth, UK, a dockyard city with a historically large ship building industry for which significant amounts of asbestos was used. This study was designed to examine complications and outcome following thoracoscopy in Portsmouth National Health Service (NHS) Trust Hospitals as part of ongoing audit and clinical governance assurances. We performed a retrospective analysis of patients undergoing thoracoscopy for unexplained exudative pleural effusion occupying at least half of the hemithorax, in our institution over a 12 month period. Demographic details and procedure date were recorded from the procedures record book in our dedicated bronchoscopy/thoracoscopy room and correlated with physician's personal records.