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Lung

, Volume 168, Supplement 1, pp 1113–1121 | Cite as

The role of thoracoscopy in the evaluation and management of pleural effusions

  • C. Boutin
  • Ph. Astoul
  • B. Seitz
Endoscopy, Biopsy Techniques In Pleural Diseases

Abstract

Diagnostic thoracoscopy is indicated in every patient where the usual investigations (including biochemistry, cytology, bacteriology, occasionally needle biopsy of the pleura) do not achieve a precise diagnosis. The percentage of so-called “idiopathic” effusions, amounting to approximately 20% in many published series, can be reduced to 4% after thoracoscopy. The sensibility of thoracoscopic biopsy reaches 93–97% of malignant or tuberculous pleural effusions. The procedure requires a short hospitalization of about 36 hr, and complications are rare.

Therapeutic thoracoscopy is frequently performed in chronic, malignant, recurrent effusions in order to achieve a pleurodesis by means of a talc poudrage under visual control. The efficacy of the poudrage in the published randomized studies is better than tetracycline. About 90% of patients are cured, the effusion being totally suppressed. Side effects are rare if the quantity of talc does not exceed 10 ml.

Key words

Thoracoscopy Exudate Pleural effusion Mesothelioma Tuberculous effusion Pleurodesis Talc poudrage 

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Copyright information

© Springer-Verlag New York Inc 1990

Authors and Affiliations

  • C. Boutin
    • 1
  • Ph. Astoul
    • 1
  • B. Seitz
    • 1
  1. 1.Hôpital la ConceptionMarseille Cedex 5France

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