Efficacy and Safety of Diagnostic Thoracoscopy in Undiagnosed Pleural Effusions

被引:110
作者
Wang, Xiao-Juan [1 ]
Yang, Yuan [1 ]
Wang, Zhen [1 ]
Xu, Li-Li [1 ]
Wu, Yan-Bing [1 ]
Zhang, Jun [1 ]
Tong, Zhao-Hui [1 ]
Shi, Huan-Zhong [1 ]
机构
[1] Capital Med Univ, Beijing Inst Resp Med, Dept Resp & Crit Care Med, Beijing Chaoyang Hosp, Beijing 100020, Peoples R China
基金
中国国家自然科学基金;
关键词
Medical thoracoscopy; Pleural biopsy; Pleural effusion; MEDICAL THORACOSCOPY; SEMIRIGID THORACOSCOPY; NEEDLE-BIOPSY; DISEASE; PLEURITIS; ACCURACY;
D O I
10.1159/000435962
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Background: The differential diagnosis of pleural effusions can present a considerable challenge, and the etiology of pleural effusions varies depending on the population studied. Objective: This study aimed to assess the efficacy and safety of medical thoracoscopy in the diagnosis of patients with undiagnosed pleural effusions in a Chinese population. Methods: Between July 2005 and June 2014, medical thoracoscopy (MT) using the semirigid instrument was performed in 833 patients with pleural effusions of unknown etiology in our Institute, where diagnostic thoracocentesis or/and blind pleural biopsy had failed to yield an answer. Demographic, radiographic, procedural, and histological data were recorded and analyzed. Results: During this 9-year study, satisfactory pleural biopsy samples were obtained in 833 patients, and MT revealed malignant pleural effusion in 342 (41.1%) patients, benign pleural effusion in 429 (51.5%) patients, and 62 (7.4%) patients could not get definite diagnoses. The overall diagnostic efficiency of MT was 92.6% (771/833). After MT, the only severe complication was empyema, seen in 3 patients (0.4%). The most common minor complication was transient chest pain (44.1%) from the indwelling chest tube. Conclusions: MT is an effective and safe procedure for diagnosing pleural effusions of undetermined causes. In areas with high tuberculosis prevalence, MT should be particularly helpful in the differential diagnosis of tuberculous pleural effusion. (C) 2015 S. Karger AG, Basel
引用
收藏
页码:251 / 255
页数:5
相关论文
共 27 条
[21]   Tuberculous Pleural Effusion [J].
Porcel, Jose M. .
LUNG, 2009, 187 (05) :263-270
[22]   COMPARISON OF NEEDLE-BIOPSY WITH CYTOLOGIC ANALYSIS FOR THE EVALUATION OF PLEURAL EFFUSION - ANALYSIS OF 414 CASES [J].
PRAKASH, UBS ;
REIMAN, HM .
MAYO CLINIC PROCEEDINGS, 1985, 60 (03) :158-164
[23]   Local anaesthetic thoracoscopy: British Thoracic Society pleural disease guideline 2010 [J].
Rahman, Najib M. ;
Ali, Nabeel J. ;
Brown, Gail ;
Chapman, Stephen J. ;
Davies, Robert J. O. ;
Downer, Nicola J. ;
Gleeson, Fergus V. ;
Howes, Timothy Q. ;
Treasure, Tom ;
Singh, Shivani ;
Phillips, Gerrard D. .
THORAX, 2010, 65 :54-60
[24]   Does 'idiopathic pleuritis' exist? Natural history of non-specific pleuritis diagnosed after thoracoscopy [J].
Venekamp, LN ;
Velkeniers, B ;
Noppen, M .
RESPIRATION, 2005, 72 (01) :74-78
[25]   Tuberculosis prevalence in China, 1990-2010; a longitudinal analysis of national survey data [J].
Wang, Lixia ;
Zhang, Hui ;
Ruan, Yunzhou ;
Chin, Daniel P. ;
Xia, Yinyin ;
Cheng, Shiming ;
Chen, Mingting ;
Zhao, Yanlin ;
Jiang, Shiwen ;
Du, Xin ;
He, Guangxue ;
Li, Jun ;
Wang, Shengfen ;
Chen, Wei ;
Xu, Caihong ;
Huang, Fei ;
Liu, Xiaoqiu ;
Wang, Yu .
LANCET, 2014, 383 (9934) :2057-2064
[26]   Semi-rigid thoracoscopy for undiagnosed exudative pleural effusions: a comparative study [J].
Wang Zhen ;
Tong Zhao-hui ;
Li Hong-jie ;
Zhao Ting-ting ;
Li Xu-yan ;
Xu Li-li ;
Luo Jing ;
Jin Mu-lan ;
Li Rui-sheng ;
Wang Chen .
CHINESE MEDICAL JOURNAL, 2008, 121 (15) :1384-1389
[27]  
Wilsher M L, 1998, Respirology, V3, P77, DOI 10.1111/j.1440-1843.1998.tb00100.x