Abstract

MEDICAL THORACOSCOPY IN UNDIAGNOSED PLEURAL EFFUSION CASES- OUR EXPERIENCE FROM A TERTIARY CARE CENTER IN KERALA

Author(s): Mohan Ajai1, Kummannoor Parameswaran Pilai Venugopal2, Puthusseril Thomas George3, Vishnu Narayan Kiran4

BACKGROUND
Aetiological diagnosis in exudative pleural effusions may be difficult in resource poor settings. Medical thoracoscopy is an excellent tool to establish diagnosis in patients with exudative pleural effusion of unclear origin even after routine diagnostic work up. Diagnostic efficacy, indications and complications of medical thoracoscopy need to be assessed further.
MATERIALS AND METHODS
The study was conducted among 61 patients over a period of 18 months. Medical thoracoscopy was performed in all the patients fit to undergo the procedure, in whom the diagnosis remained obscure after the routine initial work up.
RESULTS
Pleural biopsy was performed in all 61 cases. A diagnosis could be established by medical thoracoscopy in 54 of these cases, which corresponds to 88.5% diagnostic yield. No significant complications were noted in the study. An average 4.75 days of post-procedure intercostal tube drainage was required.
CONCLUSION
In patients with exudative pleural effusions, remaining undiagnosed after preliminary investigations, medical thoracoscopy is a safe and reliable procedure for obtaining pleural biopsy and establishing a diagnosis. With proper patient selection and adequate expertise complications of the procedure can be minimised to negligible rates.
KEYWORDS
Medical Thoracoscopy, Pleuroscopy, Pleural Effusion, Pleural Biopsy.
HOW
TO CITE THIS ARTICLE: Ajai M , Venugopal KPP , George PT , et al