Publication:

Medical thoracoscopy: a retrospective analysis in a tertiary care centre

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.