Diagnostic Yield of Medical Thoracoscopy in Undiagnosed Pleural Effusion

One of the most common indications for pleuroscopy is undiagnosed pleural effusion, which comprises about 25% of all cases of pleural effusions, which remain undiagnosed despite primary tests. Pleuroscopy was performed for the first time in Iran in Masih Daneshvari hospital located in Tehran. The aim of this study was to assess the diagnostic yield of pleuroscopy performed in this center in Iran.
Three-hundred patients with undiagnosed pleural effusions were enrolled in this study. For all patients, primary tests including pleural effusion analysis, cytology and closed pleural biopsy (if needed) were conducted and all of them were inconclusive. The semirigid thoracoscopy (pleuroscopy) was performed for all patients for diagnostic purposes.
Eighty-seven percent of the peluroscopies were diagnostic and 67% of them were diagnosed as malignancy while the rest were diagnosed as tuberculosis. Only 11 patients developed minor complications.
In conclusion, pleuroscopy is a safe procedure when performed by a skilled and experienced practitioner; it has a high diagnostic yield and results in only minor complications.