Role of medical thoracoscopy in the diagnosis of pleural effusions

• Published in: Indian journal of tuberculosis Vol. 69; no. 4; pp. 584 - 589
• Main Authors: Tousheed, Syed Zulkharnain, Ranganatha, Ramanjaneya, Hemanth Kumar, M., Manjunath, P.H., Philip, Danne S., Punitha, M., Sagar, Chandrasekar, Dutt, Tiyas Sen, Murali Mohan, B.V., Zuhaib, Muhammed, Annapandian, Vellaichamy M.
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.10.2022
• Subjects: Medical thoracoscopy; Parapneumonic effusions; Pleural effusion; Rigid thoracoscopy; Semirigid thoracoscopy; Semirigid thoracoscopy; Pleural effusion; Medical thoracoscopy; Parapneumonic effusions; Rigid thoracoscopy
• ISSN: 0019-5707
• DOI: 10.1016/j.ijtb.2021.09.005

Medical thoracoscopy (semi-rigid and rigid thoracoscopy) have revolutionized the management of undiagnosed pleural effusions. Though semi-rigid thoracoscopy has a good diagnostic yield in malignant and tubercular effusions, its role in the management of a complicated pleural effusions is debatable. Hence, rigid thoracoscopy becomes handy in these cases. The present study looked into the role of medical thoracoscopy in the diagnosis of pleural effusions in different conditions. This study included all patients who underwent medical thoracoscopy at our center between May-2010 and March-2020. Basic demographics data, type of medical thoracoscopy used, and histopathology details were collected and analyzed. A total of 373 patients were subjected to medical thoracoscopy (202 semi-rigid thoracoscopy and 171 rigid thoracoscopy). Out of whom 246 (66%) were males, the mean age was 51.9 ± 13.2 years. Diagnosis was achieved in 370 patients with a yield of 99.2%. The diagnostic yield in semi-rigid thoracoscopy was 99.5% with lung malignancy being the most common diagnosis (41%; n = 81), followed by tuberculosis (31%; n = 61). The diagnostic yield in rigid thoracoscopy was 100% in our study. Along with high diagnostic yield, complete drainage and lung expansion was seen in 93.5% (160 out of 171 patients) without requiring a second procedure. Semi-rigid thoracoscopy and rigid thoracoscopy should complement each other in the diagnosis of pleural effusions. Rigid thoracoscopy should be considered as the procedure of choice in a complicated pleural effusion. •Medical thoracoscopy is useful in the diagnosis of tubercular effusions with high diagnostic yield.•Semi-rigid thoracoscopy is useful in simple pleural effusions.•Rigid thoracoscopy is useful in complicated pleural effusions.