Diagnostic Value and Safety of Medical Thoracoscopy in the Management of Exudative Pleural EffusionMehmet Akif Özgül1, Erdoğan Çetinkaya1, Elif Tanrıverdi1, Mustafa Çörtük2, Murat Acat2, Şule Gül1, Ekrem Cengiz Seyhan3, Derya Özden Omaygenç4, Hasan Akın5, Kenan Abbaslı1, Hilal Onaran6
1Clinic of Chest Diseases, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
2Department of Chest Diseases, Karabük University School of Medicine, Karabük, Turkey
3Department of Chest Disease, Medipol Universty School of Medicine, İstanbul, Turkey
4Clinic of Anesthesiology, Yedikule Chest Diseases and Chest Surgery Education and Research Hospital, İstanbul, Turkey
5Clinic of Thoracic Surgery, Yedikule Chest Diseases and Chest Surgery Education and Research Hospital, İstanbul, Turkey
6Clinic of Chest Disease, Merzifon Kara Mustafa Paşa State Hospital, Amasya, Turkey
Objective: Medical thoracoscopy is a minimally invasive procedure that is performed by experienced pulmonologists under local anesthesia and conscious intravenous sedation. It allows direct observation and evaluation of the pleural space. Our aim is to evaluate the diagnostic efficacy and safety of this procedure while presenting our results of medical thoracoscopy performed by rigid thoracoscopy in our clinic.Keywords: Anesthesia, local, pleural effusion, thoracoscopy
Methods: Thirty-seven patients who had gone thorough medical thoracoscopy between March 2011 and August 2014 were evaluated retrospectively.
Results: Of these 37 patients, 26 were male and the average age was 50.94±15.38 years. Fourteen patients had right-sided pleural effusion, whereas 23 had left-sided pleural effusion. Closed pleural biopsy was performed previously in 16 patients with no diagnostic results. In 36 patients (97.3%), a specific diagnosis was achieved. One patient, diagnosed as lymphocytic pleuritis by medical thoracoscopy, underwent decortication and the pathology was consistent with biphasic malignant pleural mesothelioma. Another patient, diagnosed as chronic nonspecific pleuritis with medical thoracoscopy, underwent decortication and the diagnosis was fibrinous pleuritis characterized by extensive fibrosis. Three patients had expansion defects during the post-operative period. Hemothorax occurred in one patient that died of respiratory failure on day 34 of hospitalization. The median length of stay in the hospital after the procedure was 5 days (134).
Conclusion: Medical thoracoscopy is a secure procedure with high diagnostic value in the management of exudative pleural effusion.
Mehmet Akif Özgül, Erdoğan Çetinkaya, Elif Tanrıverdi, Mustafa Çörtük, Murat Acat, Şule Gül, Ekrem Cengiz Seyhan, Derya Özden Omaygenç, Hasan Akın, Kenan Abbaslı, Hilal Onaran. Diagnostic Value and Safety of Medical Thoracoscopy in the Management of Exudative Pleural Effusion. Eurasian J Pulmonol. 2016; 18(3): 139-142
Corresponding Author: Mehmet Akif Özgül, Türkiye