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Investigation into role of medical pleuroscopy in the diagnosis and management of patients with pleural diseases

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Indian Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Background

Pleuroscopy is a minimal invasive technique which allows direct visualization of the pleura, removal of the pleural fluid and biopsy of the pleura through single skin incision. Pleuroscopy provides an accurate diagnosis in effusions of unknown aetiology. The present study aimed to investigate the safety and utility of medical pleuroscopy in diagnosis and management of patients with pleural effusion.

Methods

A retrospective observational study of 38 patients who undervent medical pleuroscopy procedure from July 2008 to April 2009 at Sterling Hospital, Ahmedabad, India.

Results

In our study majority of the patients had pleural nodules while empyema, pleural thickening, patchy pleuritis and apical blebs were the findings in the rest. Normal pleuroscopy findings were observed in 2 patients. Therapeutic pleuroscopy (Adhesionolysis and/or pleurodesis) was performed in 16 patients. Pleurodesis was performed in 5 patients and adhesionolysis was performed in 9 patients, while in 2 patients adhesionolysis and pleurodesis was performed. Sclerosing agents used for pleuodesis were betadine solution(6 cases) and oxytetracycline( 1 case). Success rate of betadine pleurodesis was 83.3 %(5 of 6 cases). Pleuroscopy alongwith biopsy demonstrated diagnostic yield, sensitivity and specificity of 100 %. Minor complications related to the pleuroscopy procedure were bleeding, surgical emphysema and infection with overall incidence rate of <1 %. Procedure related mortality was zero.

Conclusions

Our data suggests that pleuroscopy is a safe, well-tolerated procedure with minimal risk allowing accurate diagnosis and therapeutic interventions in patients with indeterminate and malignant recurrent pleural effusion.

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Authors and Affiliations

  1. Department of Pharmacology, L. M. College of Pharmacy, Ahmedabad, 380009, Gujarat, India

    Anita Arunkumar Mehta, Ankita Harishkumar Soni & Sanjay Arjunsinh Parmar

  2. Sterling Hospital, Ahmedabad, 380052, Gujarat, India

    Mukesh Nathabhai Patel, Tushar Bhagvatbhai Patel, Harjit Sohansingh Dumra & Varun Rameshbhai Patel

  3. Sparsh Hospital, Near Vedant Hospital, Ahmedabad, Gujarat, India

    Mukesh Nathabhai Patel, Tushar Bhagvatbhai Patel, Harjit Sohansingh Dumra & Varun Rameshbhai Patel

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  1. Anita Arunkumar Mehta
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Correspondence to Anita Arunkumar Mehta.

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Mehta, A.A., Patel, M.N., Soni, A.H. et al. Investigation into role of medical pleuroscopy in the diagnosis and management of patients with pleural diseases. Indian J Thorac Cardiovasc Surg 28, 120–126 (2012). https://doi.org/10.1007/s12055-012-0145-5

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  • DOI: https://doi.org/10.1007/s12055-012-0145-5

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