{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T12:09:17Z","timestamp":1747224557256,"version":"3.40.5"},"reference-count":7,"publisher":"PAGEPress Publications","license":[{"start":{"date-parts":[[2022,11,2]],"date-time":"2022-11-02T00:00:00Z","timestamp":1667347200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Monaldi Arch Chest Dis"],"abstract":"<jats:p>Medical thoracoscopy is a minimally invasive single-port endoscopic technique that allows for direct visualization of the pleural surface as well as diagnostic and therapeutic procedures. When fibrous adhesions are extensive, its utility is limited. In patients with malignant pleural effusion and loculated effusion, fibrinolytics have been used through chest drainage to break down septations to relieve breathlessness and to improve pleurodesis success We described the use of intrapleural fibrinolytics during a medical thoracoscopy to break the septations and perform pleural biopsies in a patient with multiloculated pleural effusion. To the best of our knowledge, no studies on this subject have been published in the literature, only case reports. We believe that direct instillation of fibrinolytics during medical thoracoscopy is safe and has the potential to increase both the therapeutic and diagnostic capacity of medical thoracoscopy and fibrinolysis.<\/jats:p>","DOI":"10.4081\/monaldi.2022.2400","type":"journal-article","created":{"date-parts":[[2022,11,4]],"date-time":"2022-11-04T10:30:21Z","timestamp":1667557821000},"source":"Crossref","is-referenced-by-count":0,"title":["Intracavitary fibrinolysis directly under vision during medical thoracoscopy: a case report"],"prefix":"10.4081","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5062-4733","authenticated-orcid":false,"given":"Emanuele","family":"Stirpe","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Floriana","family":"Bardaro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1984-5420","authenticated-orcid":false,"given":"Johanna","family":"K\u00f6hl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2549","published-online":{"date-parts":[[2022,11,2]]},"reference":[{"key":"22355","doi-asserted-by":"crossref","unstructured":"Murthy V, Bessich JL. Medical thoracoscopy and its evolving role in the diagnosis and treatment of pleural disease. J Thorac Dis 2017;9:S1011-21.","DOI":"10.21037\/jtd.2017.06.37"},{"key":"22356","doi-asserted-by":"crossref","unstructured":"Rahman NM, Ali NJ, Brown G, et al. Local anaesthetic thoracoscopy: British Thoracic Society Pleural Disease Guideline 2010. Thorax 2010;65:ii54-60.","DOI":"10.1136\/thx.2010.137018"},{"key":"22357","doi-asserted-by":"crossref","unstructured":"Khemasuwan D, Sorensen J, Griffin DC. Predictive variables for failure in administration of intrapleural tissue plasminogen activator\/deoxyribonuclease in patients with complicated parapneumonic effusions\/empyema. Chest 2018;154:550-6.","DOI":"10.1016\/j.chest.2018.01.037"},{"key":"22358","doi-asserted-by":"crossref","unstructured":"Banka R, Terrington D, Mishra EK. Management of septated malignant pleural effusions. Curr Pulmonol Rep 2018;7:1-5.","DOI":"10.1007\/s13665-018-0194-3"},{"key":"22359","doi-asserted-by":"crossref","unstructured":"Thomas R, Piccolo F, Miller D, MacEachern PR, et al. Intrapleural fibrinolysis for the treatment of indwelling pleural catheter-related symptomatic loculations: A multicenter observational study. Chest 2015;148:746-51.","DOI":"10.1378\/chest.14-2401"},{"key":"22360","doi-asserted-by":"crossref","unstructured":"Terashita S, Kawachi H, Horikawa S, et al. Intrapleural urokinase directly under medical thoracoscopy for the diagnosis of malignant pleural mesothelioma with severe multiloculated pleural effusions. J Bronchology Interv Pulmonol 2019;26:e26-7.","DOI":"10.1097\/LBR.0000000000000576"},{"key":"22361","doi-asserted-by":"crossref","unstructured":"Terashita S, Kawachi H, Tajiri T, et al. Intrapleural urokinase directly under medical thoracoscopy for the diagnosis of tuberculous pleurisy. Respirol Case Rep 2019;8:e00498.","DOI":"10.1002\/rcr2.498"}],"container-title":["Monaldi Archives for Chest Disease"],"original-title":[],"link":[{"URL":"https:\/\/www.monaldi-archives.org\/index.php\/macd\/article\/download\/2400\/1547","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.monaldi-archives.org\/index.php\/macd\/article\/download\/2400\/1547","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,4]],"date-time":"2022-11-04T10:30:32Z","timestamp":1667557832000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.monaldi-archives.org\/index.php\/macd\/article\/view\/2400"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,2]]},"references-count":7,"URL":"https:\/\/doi.org\/10.4081\/monaldi.2022.2400","relation":{},"ISSN":["2532-5264","1122-0643"],"issn-type":[{"type":"electronic","value":"2532-5264"},{"type":"print","value":"1122-0643"}],"subject":[],"published":{"date-parts":[[2022,11,2]]}}}