HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

Electronic Letters to:

INTERVENTIONAL PULMONOLOGY: Biswajit Chakrabarti, Ida Ryland, John Sheard, Christopher J. Warburton, and John E. Earis The Role of Abrams Percutaneous Pleural Biopsy in the Investigation of Exudative Pleural Effusions Chest 2006; 129: 1549-1555 [Abstract] [Full text] [PDF]

eLetters: Submit a response to this article

Electronic letters published:

Training in Closed Pleural Biopsy

Ben J Green   (24 July 2006)

Training in Closed Pleural Biopsy 24 July 2006
Ben J Green, Doctor (Specialist Registrar Respiratory Medicine) Southampton General Hospital (UK) Send letter to journal: Re: Training in Closed Pleural Biopsy benjgreen{at}doctors.org.uk Ben J Green	Charabarti et al (1) present a retrospective review of the use of Abrams percutaneous biopsy in a large urban hospital between 1997 and 2003. It was concluded that blind pleural biopsy could be safely performed by all grades of medical staff. A sensitivity of 38% for malignant disease was observed which supported the continued use of closed pleural biopsy in the investigation of exudative pleural effusion. However, this period has seen the increasing use of image-guided and thoracoscopic pleural biopsy. There has also been an increase in the use of seldinger chest tube insertion without the opportunity for pleural biopsy while placing a surgical intercostal drain. This has led to a reduction in the number of Abrams biopsies performed with an inevitable effect on training. A survey of respiratory specialist registrars (equivalent to pulmonary fellow or trainee specializing in respiratory medicine) in the Wessex region of the UK has highlighted the declining opportunity to practice this procedure. Over the last 2 years, on average, trainees had performed 2.5 procedures (11.5 total over the course of their training). 62% of respondents felt competent in the procedure. 23% felt confident of obtaining pleural tissue. 22% felt they performed enough procedures to maintain competency (unpublished data). Blind pleural biopsy may remain of value in the investigation of exudative effusion following negative thoracocentesis. It may have health economic benefits in negating the need for image guided or thoracoscopic biopsy, but if doctors do not perform enough to remain competent in the procedure should we continue to use it? Ben Green Specialist Registrar in Respiratory Medicine Southampton General Hospital (UK) (1) Chakrabarti et al. Chest 2006;129;1549-1555