Beheshtirouy Samad, Kakaei Farzad, Mirzaaghazadeh Mohammad
Department of Thoracic Surgery, Tabriz University of Medical Sciences, Tabriz, Iran.
J Cardiovasc Thorac Res. 2013;5(3):87-90. doi: 10.5681/jcvtr.2013.019. Epub 2013 Oct 5.
An undiagnosed exudative pleural effusion is often a difficult diagnostic dilemma that needs further histological study for a definitive etiological diagnosis. Video assisted rigid thoracoscopy is a minimally invasive procedure with a minor morbidity and mortality risk that could resolve this problem.
Between January 2010 and December 2011, we performed thoracoscopy in 26 patients for diagnosis of undiagnosed exudative pleural effusion. Clinical and paraclinical data of patients were collected prospectively and analyzed.
Sole pleural effusion was the most common CT scan finding seen in 17 (65.4%) patients. Thoracoscopy was diagnostic in 24 patients (92.3%). The pathologic findings were carcinoma (46.2%), tuberculosis (30.8%) and chronic inflammation without a definitive microbiologic culture (15.4%). Surprisingly mean ADA level in the tuberculosis group was in normal range. No mortality or complication related to our operation was observed.
Video assisted thoracoscopy is a minimally invasive procedure with a high definitive diagnostic accuracy in the evaluation of tuberculosis and malignant pleural effusions. Pulmonologist should refer these patients sooner to decrease the waiting period of diagnosis and treatment of such conditions.
未确诊的渗出性胸腔积液常常是一个诊断难题，需要进一步进行组织学研究以明确病因诊断。电视辅助硬质胸腔镜检查是一种微创手术，具有较低的发病率和死亡率风险，能够解决这一问题。
在2010年1月至2011年12月期间，我们对26例未确诊的渗出性胸腔积液患者进行了胸腔镜检查。前瞻性收集并分析了患者的临床和辅助检查数据。
单纯胸腔积液是17例（65.4%）患者最常见的CT扫描表现。胸腔镜检查对24例患者（92.3%）具有诊断价值。病理结果为癌（46.2%）、结核（30.8%）和无明确微生物培养结果的慢性炎症（15.4%）。令人惊讶的是，结核组的平均ADA水平在正常范围内。未观察到与我们的手术相关的死亡或并发症。
电视辅助胸腔镜检查是一种微创手术，在评估结核性和恶性胸腔积液方面具有较高的确诊诊断准确性。肺科医生应尽早转诊这些患者，以缩短此类疾病的诊断和治疗等待期。
