Role of Video Assisted Thoracoscopic Surgery in Pleural Effusion

Abstract

Introduction: Many cases of pleural effusions remain undiagnosed even after investigations including Computed tomography (CT) chest, pleural fluid analysis. Role of Video Assisted Thoracoscopic Surgery (VATS) in undiagnosed pleural effusion is still controversial. VATS has the advantage of taking biopsy under direct vision and therapeutic procedures can be done in the same sitting. Aim: To evaluate the role of VATS in the diagnosis and management of pleural effusions. Materials and Methods: The study was conducted in the Department of Surgery, Dayanand Medical College and Hospital, Ludhiana, Punjab, India for a period of one and half year from January 2017 to May 2018. Efficacy of VATS as a diagnostic and therapeutic procedure was evaluated in patients with undiagnosed pleural effusion. Results: A total of 54 patients were included in the study. Diagnostic yield of VATS in present study was 100%. The most common diagnosis was parapneumonic effusion in 31.5% of the patients followed by chronic non-specific inflammation and tuberculosis in 25.9% patients each. Malignancy was final diagnosis in four patients. Some sort of therapeutic procedure was done in all patients and effective therapeutic yield of VATS in present study was 96.3%. Conclusion: This study adds to substantial data about the high diagnostic yield and high therapeutic efficacy of VATS in pleural effusions. The diagnostic yield of VATS for undiagnosed effusion is better than repeat thoracocentesis with the added advantage of therapeutic intervention if needed with a high success rate.

Keywords

• diagnosis
• empyema
• exudative
• parapneumonic effusion
• therapeutic
• thoracic surgery
• tuberculosis