See KC. Performing medical thoracoscopy safely in the outpatient setting: A case report. World J Clin Cases 2026; 14(23): 121367 [DOI: 10.12998/wjcc.121367]
Corresponding Author of This Article
Kay Choong See, FCCP, FRCPE, MRCP, Adjunct Associate Professor, Division of Respiratory and Critical Care Medicine, Department of Medicine, National University Hospital, Level 10, 1E Kent Ridge Road, NUHS Tower Block Singapore, Singapore 119228, Singapore. kaychoongsee@nus.edu.sg
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case-report
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See KC. Performing medical thoracoscopy safely in the outpatient setting: A case report. World J Clin Cases 2026; 14(23): 121367 [DOI: 10.12998/wjcc.121367]
World J Clin Cases. Aug 16, 2026; 14(23): 121367 Published online Aug 16, 2026. doi: 10.12998/wjcc.121367
Performing medical thoracoscopy safely in the outpatient setting: A case report
Kay Choong See
Kay Choong See, Division of Respiratory and Critical Care Medicine, Department of Medicine, National University Hospital, Singapore 119228, Singapore
Author contributions: See KC is responsible for all elements of the manuscript.
AI contribution statement: AI was not used to write the manuscript. AI tools were not used to generate original scientific data, perform independent scientific analyses, or draw scientific conclusions.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: See KC has no conflicts of interest in relation to this paper.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Kay Choong See, FCCP, FRCPE, MRCP, Adjunct Associate Professor, Division of Respiratory and Critical Care Medicine, Department of Medicine, National University Hospital, Level 10, 1E Kent Ridge Road, NUHS Tower Block Singapore, Singapore 119228, Singapore. kaychoongsee@nus.edu.sg
Received: March 23, 2026 Revised: June 16, 2026 Accepted: June 26, 2026 Published online: August 16, 2026 Processing time: 142 Days and 11.2 Hours
Abstract
BACKGROUND
Outpatient medical thoracoscopy offers a minimally invasive alternative to inpatient or surgical thoracoscopy for pleural biopsy, potentially reducing healthcare utilization while maintaining safety.
CASE SUMMARY
A 71-year-old man with metastatic epidermal growth factor receptor mutant lung adenocarcinoma developed progressive disease with an enlarging left pleural effusion requiring tissue biopsy for clinical trial enrolment. As no other site was readily accessible and the patient preferred ambulatory care, the patient underwent outpatient medical thoracoscopy under local anesthesia and light conscious sedation. After one liter of pleural fluid was drained, the proceduralist identified multiple pleural nodules and took twenty parietal pleural biopsies without complications. After three hours of clinical observation, the proceduralist removed the patient’s chest tube, allowing same-day discharge. Histology confirmed non-small cell carcinoma. At two-week follow-up, the patient remained well with a healed wound and no procedure-related complications.
CONCLUSION
In carefully selected stable patients, outpatient medical thoracoscopy can provide safe, effective pleural biopsy and drainage while avoiding hospitalization.
Core Tip: Medical thoracoscopy for pleural biopsy gives excellent yields exceeding 90% but patients may require hospitalization, which increases logistic and cost barriers. Case series are now available to support the effective and safe performance of outpatient medical thoracoscopy though these do not provide detailed principal considerations, procedural tips, and periprocedural recommendations. Using a case example, this paper aims to illustrate the principal periprocedural considerations for outpatient medical thoracoscopy and provide appropriate recommendations.
