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.