Role of semi rigid thoracoscopy in the diagnosis of exudative pleural effusion : Assiut University Hospital experience

Abstract EN

Background: 1 he procedure of medical thoracoscopy provides a window into the pleural space to perform biopsy under direct visualization, particularly when thoracocentesis and closed pleural biopsy arc inconclusive.

The development of the semirigid thoracoscope, which is handled similarly to a bronchoscope, has made this procedure feasible and successful by most pulmonologists.

It remains unknown whether certain pleural lesions, as visualized on thoracoscopy, has potential diagnostic value.

We aimed to assess diagnostic value of the semirigid thoracoscope and correlate endoscopic findings with the histological diagnosis. Patients and methods: From January 2010 to Januas^ 2012, 64 diagnostic medical thoracoscopies were performed to 64 patients w ith undiagnosed pleural effusion, in a tertiary care university hospital.

All patients had thoracoscopy with visually directed biopsies and pleural lesion rating under local anaesthesia and mild sedation.

Endoscopic findings were classified as; pleura! thickening, nodules, adhesions and whitish lymphedema. Results: The yield of the thoracoscopic biopsy in reaching the final diagnosis was (98.4%).

T'horacoscopic diagnosis of malignancy in our study was (76.6%) whereas benign diagnosis was (23.4%).

Thoracoscopy was well tolerated under local anaesthesia and in most cases it was a one day procedure.

Significant relations were found between endoscopic and pathology findings.

Presence of nodules and lymphedema had a trend of positive relation with malignancy, p-value (0.002) and (0.009) respectively.