Associate Professor, Department of Pulmonary Medicine, Smt NHL Municipal Medical College; Corresponding Author.
Associate Professor, Department of Pulmonary Medicine, AMC MET Medical College.
J Assoc Physicians India. 2023 Feb;71(2):11-12. doi: 10.5005/japi-11001-0172.
b/pulli>To know the diagnostic yield of pleuroscopy (medical thoracoscopy) in cases of pleural effusions which remain undiagnosed after routine initial investigations.lili>To notice the different gross pleuroscopic findings during the procedure.lili>To observe various histopathological reports of pleural biopsy taken through medical thoracoscopy.lili>To know the various complications of pleuroscopy in patients undergoing this procedure.li/ulp!
A total of 56 patients having undiagnosed pleural effusion were taken for study after informed written consent. All patients underwent medical thoracoscopy. The clinical, demographic, and radiological profile of patients was recorded. Gross pleuroscopic findings and histopathological reports of the pleural biopsy were noted. All patients were observed for any complications that occurred during or after the procedure.
Diagnostic yield of thoracoscopy in the present study was 91.07% (malignant pleural effusion 75% and tuberculous pleuritis 12.5%). Adenocarcinoma was the commonest malignancy in 60.71% of patients amongst malignant pleural effusion in the present study. Very few complications were recorded. The most common postprocedure complication was subcutaneous emphysema (12.5%) followed by pneumothorax (10.78%).
Thoracoscopy gives excellent diagnostic yield in undiagnosed pleural effusion without major complications, and should be utilized wherever feasible.
b/pulli>了解胸腔镜检查(内科胸腔镜检查)在常规初始检查后仍未确诊的胸腔积液病例中的诊断效果。lili>注意在手术过程中出现的不同大体胸腔镜发现。lili>观察通过内科胸腔镜检查获取的胸膜活检的各种组织病理学报告。lili>了解接受该程序的患者中胸腔镜检查的各种并发症。li/ulp!
在知情同意书的情况下,共对 56 名患有不明原因胸腔积液的患者进行了研究。所有患者均接受了内科胸腔镜检查。记录了患者的临床、人口统计学和放射学特征。记录了大体胸腔镜发现和胸膜活检的组织病理学报告。观察所有患者在手术过程中或之后是否发生任何并发症。
本研究中胸腔镜的诊断率为 91.07%(恶性胸腔积液 75%,结核性胸膜炎 12.5%)。腺癌是本研究中恶性胸腔积液患者中最常见的恶性肿瘤,占 60.71%。记录的并发症很少。最常见的术后并发症是皮下气肿(12.5%),其次是气胸(10.78%)。
胸腔镜检查在未确诊的胸腔积液中具有出色的诊断效果,且无严重并发症,应尽可能在可行的情况下使用。