1.Dry Medical Thoracoscopy with Artificial Pneumothorax Induction: A Scoping Review
Nai-Chien HUAN ; Larry Ellee NYANTI ; Emilia Sheau Yuin TOH ; Kong Meng TUNG ; Fui Bee WOO ; Vikneshwara SHANMUGAM ; Sarvin VIGNESH ; Y. C. Gary LEE
Tuberculosis and Respiratory Diseases 2026;89(2):287-296
Background:
Dry medical thoracoscopy (MT) allows access into the pleural cavity in the absence of effusion; but its role, safety, and techniques remain poorly defined. This scoping review summarises current evidence on indications, procedural approaches, diagnostic yield, and safety of dry MT; and highlights gaps to guide future research.
Methods:
We conducted a scoping review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. PubMed and Google Scholar databases were systematically searched for original studies reporting on dry MT involving pneumothorax induction. Study selection and data extraction followed the Joanna Briggs Institute methodology.
Results:
Thirteen studies involving 357 patients were included. 146 cases (40.9%) were completely ‘dry’ (complete absence of pleural fluid). Techniques for pneumothorax induction varied, including blunt dissection, Veress needle, Boutin needle, bladeless trocar, Saugman cannula and guidewire-assisted catheter insertion. Procedural success ranged from 80.6% to 100%, though definitions were inconsistently reported. Thoracic ultrasound was frequently used for site selection and needle guidance, but standardised criteria were lacking. Malignancy and chronic pleurisy were common histological findings. Complications occurred in 5.9% of cases, most commonly chest pain. No studies reported long-term follow-up.
Conclusion
Dry MT appears technically feasible and generally safe. Heterogeneity in techniques, outcome definitions, and limited follow-up constrain further interpretation. Future studies should aim to standardise procedural definitions, evaluate predictors of success, and compare pneumothorax induction methods. Prospective research with long-term outcomes is needed to definite the role of dry MT more clearly.
2.Determinants of Willingness to Undergo Lung Cancer Screening among High- Risk Current and Ex-smokers in Sabah, Malaysia: A Cross-Sectional Pilot Study
Larry Ellee NYANTI ; Chia Zhen CHUA ; Han Chuan LOO ; Cheng Zhi KHOR ; Emilia Sheau Yuin TOH ; Rasvinder Singh GILL ; Eng Tat CHAN ; Ker Yin TAN ; Taufiq ROSLI ; Muhammad Aklil Abd RAHIM ; Arfian IBRAHIM ; Nai Chien HUAN ; Hema Yamini Devi RAMARMUTY ; Kunji Kannan Sivaraman KANNAN
Tuberculosis and Respiratory Diseases 2023;86(4):284-293
Background:
Attitudes towards smoking, lung cancer screening, and perceived risk of lung cancer have not been widely studied in Malaysia. The primary objective of this study was to describe the factors affecting the willingness of high-risk current smokers and ex-smokers to undergo low-dose computed tomography (LDCT) screening for lung cancer.
Methods:
A prospective, cross-sectional questionnaire study was conducted in current smokers or ex-smokers aged between 55 and 80 years at three hospitals in Kota Kinabalu, Sabah, Malaysia. The questionnaire recorded the following parameters: perceived lung cancer risk; Prostate Lung Colon Ovarian Cancer 2012 risk prediction model excluding race and ethnicity predictor (PLCOm2012norace); demographic characteristics; psychosocial characteristics; and attitudes towards lung cancer and lung cancer screening.
Results:
A vast majority of the 95 respondents (94.7%) indicated their willingness to undergo screening. Stigma of lung cancer, low levels of knowledge about lung cancer symptoms, concerns about financial constraints, and a preference for traditional medication were still prevalent among the respondents, and they may represent potential barriers to lung cancer screening uptake. A desire to have an early diagnosis (odds ratio [OR], 11.33; 95% confidence interval [CI], 1.53 to 84.05; p=0.02), perceived time constraints (OR, 3.94; 95% CI, 1.32 to 11.73; p=0.01), and proximity of LDCT screening facilities (OR, 14.33; 95% CI, 1.84 to 111.4; p=0.01) had significantly higher odds of willingness to undergo screening.
Conclusion
Although high-risk current smokers and ex-smokers are likely to undergo screening for lung cancer, several psychosocial barriers persist. The results of this study may guide the policymakers and clinicians regarding the need to improve lung cancer awareness in our population.

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