Diagnostic efficacy of thoracoscopy in recurrent undiagnosed pleural effusion

Abstract

Background: Pleural effusion (PE) can occur as complication of many diseases. When pleural fluid is detected, an effort should be made to determine etiology. 20% of PEs remain undiagnosed even after all investigations. The study was to identify the different etiological conditions in recurrent pleural effusion using thoracoscopy. And to determine the etiology of undiagnosed recurrent pleural effusion by thoracoscopy. Methodology: Prospective, observational study conducted in a tertiary care institute over a period of three years. 42 cases of undiagnosed recurrent pleural effusion were undergone thoracoscopy. Detailed history and physical examination, thoracocentesis and pleural fluid analysis were done in all cases. Ultrasound examination and computerized tomography done in all cases before thoracoscopy. Results: Out of the 42 cases of recurrent pleural effusions, the most common type was Adenocarcinoma followed by tuberculosis. Three cases remained undiagnosed even after thoracoscopy. Conclusions: Thoracoscopy is a simple, safe, less expensive technique with low morbidity and leads to early and quick diagnosis in recurrent pleural effusions. It was concluded in our study that thoracoscopy can establish the diagnosis in 92.85% cases of recurrent pleural effusion which were negative with pleural analysis there by decreasing morbidity and mortality due to pleural diseases. Keywords: Biopsy; Malignancy; Pleural effusion; Thoracoscopy; Tuberculosis.