Role of VATS in Pleural Effusions with Unknown Etiology

The cause of pleural effusion in some patients can not be found even after biochemical, bacteriologic and cytological examinations of the pleural fluid and closed needle biopsy of the pleura. In this group of patients the next diagnostic step would be an open pleural biopsy through a limited thoracotomy or video-assisted thoracoscopic surgery (VATS), the latter procedure has replaced the former in many centers due to its advantages. In order to evaluate these advantages, 59 patients with undiagnosed pleural effusion were operated on through either limited thoracotomy or thoracoscopy form April 1998 to September 2000, in a prospective clinical trial. There were 40 males and 19 females in the age range of 10 to 89 yrs. There was no significant statistical difference between the two groups in terms of sex and age. There was no statistical difference between the two groups in terms of diagnostic accuracy, postoperative pain, hospitalization, morbidity and mortality. Based on these results and minimal scar, VATS is a safe diagnostic procedure in this group of patients replacing limited thoracotomy.)