Diagnostic Yield of Medical Thoracoscopy in Undiagnosed Exudative Pleural Effusion

Abstract

Background: The diagnosis of few pleural effusions remains undiagnosed inspite of all the biochemical and microbiological tests performed. Medical thoracoscopy has the advantage of direct visualization of pleural and real time biopsy can be taken. In areas with high tuberculosis prevalence, Medical Thoracoscopy should be particularly helpful in the differential diagnosis of tuberculous pleural effusion. Medical thoracoscopy increases the diagnostic yield in patients with pleural disease when thoracocentesis and closed pleural biopsy are non-diagnostic.

Aim of the Study: To evaluate the diagnostic yield of Medical thoracoscopy in undiagnosed exudative pleural effusions.

Patient and Methods: A total of 53 patients who underwent Medical thoracoscopy during the one-year study period were included in the study and all these patients had unilateral exudative pleural effusion which remained undiagnosed after initial pleural fluid analysis.

Results: Out of 53 patients, 27 patients had malignancy, 17 patients had tuberculosis, 9 patients had non-specific inflammation suggestive of chronic pleuritis. The diagnostic yield for a Medical thoracoscopy guided biopsies was 83.1%.

Conclusion: Medical thoracoscopy is a good diagnostic procedure for pulmonologists to evaluate undiagnosed exudative pleural effusions. It is safe and has a high diagnostic yield with minor complications.