RESUMEN
INTRODUCTION: In most of the pleural effusion, fluid analysis generally gives the etiological diagnosis but in almost 20% it remains unclear. This study was designed to determine the diagnostic yield of a pleural biopsy using semi rigid thoracoscope and its complication rates. MATERIALS AND METHODS: This was a retrospective observational study conducted in the Department of Pulmonary Medicine, AIIMS Patna. All the patients diagnosed as unexplained pleural effusion between Jan 2018 and December 2019 were included in the study. RESULTS: Total 76 out of 97 patients with unexplained exudative pleural effusion underwent medical thoracoscopy in the given period of 2 years. The mean age of the patients was 57.63 years. There were 46 males and 30 females. 38 patients (50%) had right-sided pleural effusion. More than half (52.6%) of study patients were on Anti-tubercular treatment in which only 11.84% had tuberculosis. In both unilateral and bilateral pleural effusion, the proportions of small, moderate, and large size of pleural effusions were 10.52, 42.10, and 47.36%, respectively. Thoracoscopy yielded a definitive diagnosis in 66 out of 76 patients (86.84%), and in 10 patients (13.15%), biopsy was inconclusive. Of 76 patients, malignancy was confirmed in 58 (76.31%), and tuberculosis in 8 (11.84%) patients CONCLUSION: This study concludes that, medical thoracoscopy with semi-rigid thoracoscope is an invaluable tool in the diagnosis of patients with unexplained exudative pleural effusion. It is a very simple and safe method with high diagnostic yield and associated with few complications. Malignancy was found to be the most common cause of unexplained exudative pleural effusion.
Asunto(s)
Adenocarcinoma/diagnóstico , Neoplasias Pulmonares/diagnóstico , Tuberculosis Pulmonar/diagnóstico , Adenocarcinoma/complicaciones , Diseño de Equipo , Femenino , Humanos , India , Neoplasias Pulmonares/complicaciones , Masculino , Persona de Mediana Edad , Derrame Pleural/etiología , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Centros de Atención Terciaria , Toracoscopios , Toracoscopía , Tuberculosis Pulmonar/complicacionesRESUMEN
Objective To investigate the feasibilty of the disposable tracheotomy tube as trocar in the electronic bronchoscope instead of thoracoscope. Methods 86 patients with effusion of unknown origin undergoing medical tho-racoscopy from January 2015 to October 2015, 59 male (68.6%) and 27 female (31.4 %), mean age (49.00 ± 20.00) years (15 ~ 83) years, were randomly divided into two groups, Tracheostomy tube group (group T) and Conventional chest tube group (group C). Group T uses disposable cannula tracheostomy tube as trocar, and group C received conventional medical thoracoscopy chest tube. Then compare the positive rate of pathological diagnosis, operation time, inspection fees, and other adverse reactions between the two groups. Results 40 cases (93.0%) in group T were confirmed diagnosis, including 8 cases of lung pleural metastasis, 31 cases of erculous pleurisy, 1 case of empyema, while 4 cases of unknown diagnosis (7.0%). 33 cases (76.7%) in group C were confirmed diagnosis, in-cluding 4 cases of lung pleural metastasis, 29 cases of tuberculous pleurisy, while 10 cases of unknown diagnosis (23.3 %). The difference was statistically significant between the two groups ( < 0.05). Operative time in group T was (23.86 ± 2.45) minutes, while in group C was (29.88 ± 3.67) minutes, the difference was statistically significant ( <0.05). While the complication rate was no significant difference. Conclusions It is demonstrated that the dispos-able tracheotomy tube as trocar in the electronic bronchoscope instead of thoracoscope which can shorten the opera-tion time, improve the diagnosis rate, reduce costs, worthy of promoting.