Medical Thoracoscopy: A Useful Diagnostic Tool for Undiagnosed Pleural effusion.
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Date
2014-10
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Abstract
Objective. We aimed to assess the role of medical thoracoscopy in patients with undiagnosed pleural effusion.
Methods. Patiens presenting with pleural effusion underwent three pleural aspirations. Patients in whom pleural fluid
analysis was inconclusive underwent closed pleural biopsy for diagnostic confirmation. Patients in whom closed pleural
biopsy was incolcusive underwent medical thoracoscopy using a rigid thoracoscope with a viewing angle of zero degrees
was done under local anaesthesia and sedation with the patient lying in lateral decubitus position with the affected side
up. Biopsy specimens from parietal pleura were obtained under direct vision and were sent for histopathological
examination.
Results. Of the 128 patients with pleural effusion who were studied, pleural fluid examination established the diagnosis in
81 (malignancy 33, tuberculosis 33, pyogenic 14 and fungal 1); 47 patients underwent closed pleural biopsy and a diagnosis
was made in 28 patients (malignancy 24, tuberculosis 4). The remaining 19 patients underwent medical thoracoscopy and
pleural biopsy and the aetiological diagnosis could be confirmed in 13 of the 19 patients (69%) (adenocarcinoma 10, poorly
differentiated carcinoma 2 and mesothelioma 1).
Conclusion. Medical thoracoscopy is a useful tool for the diagnosis of pleural diseases. The procedure is safe with minimal
complications.
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Keywords
Closed pleural biopsy, Medical thoracoscopy, Pleural disease, Pleural effusion
Citation
Agarwal Abhishek, Prasad Rajendra, Garg Rajiv, Verma S K, Singh Abhijeet, Husain N. Medical Thoracoscopy: A Useful Diagnostic Tool for Undiagnosed. The Indian Journal of Chest Diseases and Allied Sciences, 2014 Oct; 56 (4): 217-220.