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ORIGINAL ARTICLE
Year : 2019  |  Volume : 2  |  Issue : 3  |  Page : 100-104

Role of Rigid Thoracoscopy in Undiagnosed Pleural Effusion: A Prospective Study


1 Senior Resident, Department of Thoracic Medicine, Thanjavur Medical College and Hospital, Thanjavur, Tamil Nadu, India
2 Associate Professor, Department of Thoracic Medicine, Thanjavur Medical College, Tamil Nadu, India
3 Junior Resident, Department of Thoracic Medicine, Thanjavur Medical College, Tamil Nadu, India

Correspondence Address:
A Manimaran
Senior Resident, Department of Thoracic Medicine, Thanjavur Medical College and Hospital, Thanjavur, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/WKMP-0215.309246

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Background: Medical thoracoscopy is a minimally invasive, safe, and cost-effective procedure that allows complete visualization of pleural space, enabling diagnostic and therapeutic procedures such as pleural biopsy and talc insufflations. Conservative estimates suggest that 25% of patients seen in general pulmonologist’s practice involve pleura, of these 25% are unable to be attributed to a specific diagnosis, even after thoracentesis and closed pleural biopsy. Aim: The aim of this study was to evaluate the diagnostic yield of rigid thoracoscopy in undiagnosed pleural effusion. Methods: This prospective observational descriptive study was conducted in Thanjavur Medical College Hospital, Tamil Nadu, in the Department of Thoracic Medicine between July 2017 and December 2018. Rigid thoracoscopy equipment was used for investigation. 12 undiagnosed pleural effusion patients after thoracentesis who fulfilled inclusion and exclusion criteria were included in the study. Results: Of the 12 patients, six were male and six were female; seven had right-sided pleural effusion and five had left sided pleural effusion. Investigation reports were inconclusive except for suggesting an exudative effusion. Cytological examinations of pleural fluid were inconclusive in all the patients. After thoracoscopy, tuberculosis was diagnosed in five cases, metastases in three cases, mesothelioma in two cases, and inflammatory pathology in two cases. Conclusion: Thoracoscopy is a safe procedure with high diagnostic yield in undiagnosed exudative pleural effusion (EPE). A simple, minimally invasive low-cost investigation reduces the need for more invasive and much more expensive thoracotomy. Our study proved that rigid thoracoscopy remains the investigation of choice in all undiagnosed EPE for accurate diagnosis and management.


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