Scope of medical rigid thoracoscopy in patients with pleural effusion of unknown etiology: A prospective single center study

Authors

  • Namrata Senior Resident, Department of Pulmonary Medicine, SGPGI, Lucknow, Uttar Pradesh, India https://orcid.org/0000-0002-8635-3282
  • Amarendra Kumar Shukla Assistant Professor, Department of Pulmonary Medicine, School of Excellence in Pulmonary Medicine, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India https://orcid.org/0000-0002-5726-9778
  • Pawan Tiwari Associate Professor, Department of Pulmonary Medicine, School of Excellence in Pulmonary Medicine, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India https://orcid.org/0000-0002-5136-4221
  • Veerendra Arya Assistant Professor, Department of Medicine, School of Excellence in Pulmonary Medicine, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India https://orcid.org/0000-0003-0548-959X
  • Prahlad Prabhudesai Senior Consultant Chest Physician, Department of Respiratory Medicine, Lilavati Hospital, Mumbai, Maharashtra, India https://orcid.org/0000-0003-4070-8639

DOI:

https://doi.org/10.3126/ajms.v14i4.48316

Keywords:

Medical thoracoscopy; Pleural biopsy; Pleural effusion; Pleural mass; Pneumothorax

Abstract

Background: Pleural diseases commonly encountered are pleural effusion, pneumothorax, pleural wall thickening, and pleural mass. Medical thoracoscopy is a minimally invasive procedure that allows diagnostic and therapeutic intervention. The medical diagnostic thoracoscopy in local anesthesia is a simple, low-cost investigation with relatively high diagnostic accuracy, no mortality, and low morbidity. A diagnosis of pleural tuberculosis (TB) could be achieved in 99% of patients as against 51% using closed pleural biopsy.

Aims and Objectives: Assessment of the role of medical rigid thoracoscopy in patients with pleural effusion of unknown etiology in a tertiary health care setup. The primary objectives of the study were to evaluate the diagnostic yield of medical thoracoscopy in pleural effusion of unknown etiology.

Materials and Methods: The study duration/time frame to address the study: November 2017–February 2019 sample size with Justification Sample size: Minimum 31 patients. It was a prospective observational study. All patients admitted in hospital/daycare at LHRC presenting with pleural effusion with unknown etiology. All patients had a medical thoracoscopy, and samples were sent for microbiological and histological analysis. Clinical, thoracoscopic results and histopathological data of the patients were collected prospectively and analyzed.

Results: In this study, 28 patients out of 31 patients were diagnosed. The diagnostic yield of thoracoscopic pleural biopsy was 90.3% Out of 31 patients, the most common complication found was chest pain 48.4% (15/31), followed by 09.7% (03/31) of the cases had complications such as surgical emphysema, postoperative fever, and bleeding. There were no complications in 32.2% (10/31) patients.

Conclusion: Medical thoracoscopy is a noble procedure that helps the pulmonologist/surgeon to inspect the pleural cavity. It is a safe and effective diagnostic as well as a therapeutic tool with a high diagnostic yield. The most common differentials of undiagnosed pleural effusion cases are TB and malignancy.

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Author Biography

Namrata, Senior Resident, Department of Pulmonary Medicine, SGPGI, Lucknow, Uttar Pradesh, India

Senior Resident

Department of Pulmonary Medicine

SGPGIMS

Lucknow, Uttar Pradesh, India

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Published

2023-04-01

How to Cite

Namrata, Amarendra Kumar Shukla, Tiwari, P., Veerendra Arya, & Prahlad Prabhudesai. (2023). Scope of medical rigid thoracoscopy in patients with pleural effusion of unknown etiology: A prospective single center study. Asian Journal of Medical Sciences, 14(4), 222–229. https://doi.org/10.3126/ajms.v14i4.48316

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Original Articles