EXPERIENCE IN MEDICAL THORACOSCOPY: A FOUR-YEAR RETROSPECTIVE STUDY

Abstract

PURPOSE: To document our experience in rigid medical thoracoscopy in diagnosis of pleural effusion of undetermined origin in a four year retrospective study regarding its safety, complications and diagnostic yield. METHODS: Data of 134 patients who underwent medical thoracoscopy in Alexandria Main University Hospital, Chest department for diagnosing pleural effusion of undetermined origin were retrospectively reviewed to assess the diagnostic yield, safety and complications of rigid medical thoracoscopy, RESULTS: We reviewed records of 134 patients [62 males (46%) and 72 females (54%)]. Their mean age was 54±13.43 years. Combining histopathological and bacteriological examination results of thoracoscopic pleural biopsies, all patients were finally diagnosed except 13 patients (10%) that remained idiopathic, 97 patients (72%) were diagnosed as malignant pleural effusion (MPE)&24 (18%) patients were diagnosed as benign pleural effusion. Regarding patients with MPE, 10 patients were diagnosed as primary pleural mesothelioma. The frequency of primary tumor organ among the 87 patients with metastatic pleural disease, with no respect to patient gender, was; the lung being the most common primary organ (48%), the next three primary organ sites encountered in descending order were breast (20%), ovary and colon (5%). In 9 patients (10%) the primary site of the neoplasm was never determined. The commonest complication encountered was post-procedural pain (35 %), followed by subcutaneous emphysema (19%) CONCLUSIONS: Medical thoracoscopy showed very high diagnostic yeild. Overall, the procedure was safe even in elderly patients. No procedure related mortality was reported CLINICAL IMPLICATIONS: Medical thoracoscopy, in our experience, is safe & well-tolerated even in elderly patients with high diagnostic yield.