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CC BY-NC-ND 4.0 · South Asian J Cancer 2016; 05(01): 27-28
DOI: 10.4103/2278-330X.179700
LUNG CANCER: Original Article

A study to compare the diagnostic efficacy of closed pleural biopsy with that of the thoracoscopic guided pleural biopsy in patients of pleural effusion

Ashwini Kumar Mishra
Department of Pulmonary Medicine, King George' Medical University, Lucknow, Uttar Pradesh
,
Sanjeev Kumar Verma
Department of Pulmonary Medicine, King George' Medical University, Lucknow, Uttar Pradesh
,
Surya Kant
Department of Pulmonary Medicine, King George' Medical University, Lucknow, Uttar Pradesh
,
Ram Awadh Kushwaha
Department of Pulmonary Medicine, King George' Medical University, Lucknow, Uttar Pradesh
,
Rajiv Garg
Department of Pulmonary Medicine, King George' Medical University, Lucknow, Uttar Pradesh
,
Santosh Kumar
Department of Pulmonary Medicine, King George' Medical University, Lucknow, Uttar Pradesh
,
Ved Prakash
Department of Pulmonary Medicine, King George' Medical University, Lucknow, Uttar Pradesh
,
Ajay Verma
Department of Pulmonary Medicine, King George' Medical University, Lucknow, Uttar Pradesh
,
Mala Sagar
Department of Pathology, King George' Medical University, Lucknow, Uttar Pradesh
› Author Affiliations Source of Support: Nill.
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Abstract

Background: The diagnostic approach to exudative pleural effusion remains an underappreciated aspect of modern thoracic medicine. 15-20% of the pleural effusions remain undiagnosed. The most efficient approach to pleural exudates remains uncertain and controversial particularly if acquisition of pleural tissue is required. The clinician needs to consider various factors when confronted with the choice between closed pleural biopsy (CPB) and thoracoscopy. Hence this study was planned to compare the diagnostic efficacy of CPB and Thoracoscopic pleural biopsy (TPB). Materials and Methods: This was a prospective interventional study in patients of exudative pleural effusion. CPB was performed by Cope′s biopsy needle. Then inspection of the pleural cavity was performed by single port rigid thoracoscope (KARL, STORZ TELECAM DX II 20 2330 20) with viewing angle of zero (0) degrees and biopsy taken from the diseased or unhealthy parietal pleura. Accordingly we compared the results of CPB and TPB. Results: 46 Patients underwent this study. In all 46 patients both CPB and TPB were performed.TPB was diagnostic in 36 cases (78.2%) while CPB was diagnostic only in 10 cases i.e. 21.7%. 10 (21,7%) cases remained undiagnosed. On thoracoscopic examination 30 patients were having nodularity, 25 (54.3%) were having adhesions and 20 (43.5%) were having hyperemia. 79.3% of the patients with nodularity turned out to be malignant and 71.4% of patients with adhesions and hyperemia tubercular. Conclusions: TPB has much greater diagnostic efficacy than CPB.

Key words

Malignancy - pleural diseases - thoracoscopic pleural biopsy - tuberculosis


Publication History

Article published online:
30 December 2020

© 2016. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Hirsch A, Ruffie P, Nebut M, Bignon J, Chrétien J. Pleural effusion: laboratory tests in 300 cases. Thorax1979;34:106-12.
  • 2 James P, Gupta R, Christopher DJ, Balamugesh T. Evaluation of the diagnostic yield and safety of closed pleural biopsy in the diagnosis of pleural effusion. Indian J Tuberc 2010;57:19-24.
  • 3 Jacobeous HC. Possibility of the use of cystoscope for the investigation of serous cavities. Munch Med wochenschr1910; 57:2090-2092.
  • 4 Bowditch H. On paracentesis thoracis. Boston Surg J 1857;56:348-54.
  • 5 Cope C. New pleural biopsy needle. JAMA 1958;167:1107-8.
  • 6 Ogirala RG, Agarwal V, Vizioli LD, Pinsker KL, Aldrich TK. Comparison of the Raja and the Abrams pleural biopsy needles in patients with pleural effusion. Am Rev Respir Dis 1993;147:1291-4.
  • 7 McLeod DT, Ternouth I, Nkanza N. Comparison of the Tru-cut biopsy needle with the Abrams punch for pleural biopsy. Thora×1989;44:794-6.
  • 8 Verma S, Dubey A, Singh B. Efficacy and safety of pleural biopsy in aetiological diagnosis of pleural effusion. Int J Inf Dis. 2009;7:1
  • 9 Harris RJ, Kavuru MS, Rice TW, Kirby TJ. The diagnostic and therapeutic utility of thoracoscopy. A review. Chest 1995;108:828-41.
  • 10 Loddenkemper R, Mai J, Scheffler N, Brandt HJ. Prospective individual comparison of blind needle biopsy and of thoracoscopy in the diagnosis and differential diagnosis of tuberculous pleurisy. Scand J Respir Dis Suppl 1978;102:196-8.
  • 11 David S. Medical thorecoscopy: our experience with 155 patients. Inter J Pulmon. Med2003;1531-1535
  • 12 Harris RJ, Kavuru MS, Mehta AC, Medendorp SV, Wiedemann HP, Kirby TJ, et al. The impact of thoracoscopy on the management of pleural disease. Chest 1995;107:845-52.
  • 13 Dhanya TS, Ravindran C. Medical thoracoscopy – Minimally invasive diagnostic tool for a trained pulmonologist. Calicut Med J 2009;7:e4.
  • 14 Viskum K, Enk B. Complications of thoracoscopy. Poumon Coeur 1981;37:25-8.