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Medical thoracoscopy: a retrospective analysis in a tertiary care centre

Savita Jindal, Chirag A. Gangajalia, Pujan Parikh, V. G. Vinod, Nalin T. Shah, Kusum V. Shah.

Background: Medical thoracoscopy is a minimally invasive procedure to visualize the entire pleural surface and perform limited diagnostic and therapeutic procedures. One of the main indications for medical thoracoscopy is to obtain a diagnosis in an exudative pleural effusion when other, simpler methods non-diagnostic. Medical thoracoscopy can also be used for therapeutic procedures. The present study is an effort to analyse our experience of medical thoracoscopy in patient of undiagnosed pleural effusion.
Methods: 25 patients of pleural effusion in which diagnosis was not made by routine pleural fluid examination (biochemical/microbiological/cytological evaluation) were subjected to video thoracoscopy and biopsy, pleural fluid taken for pathological examination and therapeutic interventions such as adhesiolysis and pleurodesis were done. Intercostal drain kept.
Results: Overall yield in the present study is 92% (23 out of 25). Majority of patients had malignant effusions (19 patients - 76%), of which 8 had metastatic adenocarcinoma and 7 had malignant mesothelioma. 2 patients (8%) were diagnosed to have tuberculous pleurisy. Present study had no incidence of thoracoscopic complications.
Conclusions: We recommend that thoracoscopy shall be the Investigation of choice of undiagnosed pleural effusion as it has good yield with minimal complications.

Key words: Medical thoracoscopy, Exudative pleural effusion, Tuberculosis, Pleural metastasis, Mesothelioma

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