Diagnostic yield of medical thoracoscopy in cases of undiagnosed pleural effusion in Kobri El-Kobba Military Hospital

Abstract

Background: Recurrent and persistent pleural exudates are common in clinical practice, and in a large number of patients, thoracocentesis and blind pleural biopsy procedures do not provide a definitive diagnosis. In the Western world, the majority of these exudates are malignant. Thoracoscopy today remains the gold standard technique in providing diagnosis and management in these cases. Objectives: Diagnostic yield of medical thoracoscopy was evaluated in cases of undiagnosed pleural effusion. Patients and methods: Semi flexible medical thoracoscopy was done for 40 patients in the period between March 2010 and October 2012 in Kobri El-Kobba Military chest Hospital through double points of entry. Results: Medical thoracoscopy gave a definitive diagnosis in 38 out of 40 patients with diagnostic yield 95%. Malignancy was diagnosed in 28 patients (70%), one patient was diagnosed as empyema (2.5%), tuberculosis was found in 9 patients (22.5%), and it was non diagnostic in 2 patients (5%). The post-thoracoscopic complications in the studied group have occurred only in 4 patients (10%). Conclusion: Medical thoracoscopy is a valuable tool in the diagnosis of undiagnosed exudative pleural effusion. It is a simple and safe method with high diagnostic yield and with low complication rates.

Keywords

• Pleural effusion
• Thoracoscopy
• High diagnostic yield