Utility of Semirigid Thoracoscopy in the Diagnosis of Recurrent Undiagnosed Pleural Effusion: A Tertiary Care Experience in Central India

Abstract

Medical thoracoscopy is a minimally invasive, highly useful investigation in patients with undiagnosed pleural effusions where TB and malignant pleural effusion are clinical possibilities. Semirigid thoracoscopy is an easy outpatient procedure, done under local anaesthesia with lesser duration of hospital stay. We analysed our initial 4-year record of thoracoscopy in the Department of Pulmonary Medicine, MGM Medical College, Indore. MATERIALS AND METHODSThis cross-sectional retrospective study was done to analyse our experience of medical thoracoscopy conducted between June 2012 and May 2016. Thoracoscopy was performed for diagnosis of undiagnosed pleural effusions and data of the patients were collected retrospectively and analysed. RESULTSOf 63 patients with proven pleural malignancy, the majority of them (61.8%) had adenocarcinoma, followed by small cell carcinoma (19%). Squamous cell carcinoma and lymphoma each was diagnosed in six patients, while only three had mesotheliomas and the remaining three patients had undifferentiated pleural cancer. In 30 (29.4%) out of 102 patients, thoracoscopic pleural biopsy showed granulomatous inflammation consistent with TB. There was no major complication or mortality related to the procedure. CONCLUSIONMedical thoracoscopy is simple, safe, an easy outpatient, convenient and cost-effective procedure with a high positive diagnostic yield.