European Journal of Cardiovascular Medicine

Background: Thoracoscopy is a minimally invasive procedure that allows visualization of the pleural space and intrathoracic structures. In tuberculous pleuritis, the combined yield of histology and culture for rigid thoracoscopy was nearly 100%. The aim of the present study was to examine the diagnostic yield of medical thoracoscopy in patients with undiagnosed exudative pleural effusion. Patients and methods: This study was carried out at the Department of pulmonary medicine, SVRRGGH, TIRUPATI in the period from June 2022 to June 2023. It included 50 patients with undiagnosed pleural effusion. The included patients were subjected to full history taking, clinical examination, plain chest radiograph, ultrasonography, computed tomography of the chest, and tuberculosis assessment. Diagnostic aspiration of pleural fluid was performed by using chemical, cytological, and bacteriological analyses. Lastly, if the etiology remained unknown, a thoracoscopy was carried out. Results:  The present study included 25 men and 25 women patients, with a mean age of 54.4±16.1 years. Dyspnea was the most common presenting symptom among the studied patients. 36 (72.2%) patients had moderate right-sided pleural effusion. The diagnostic yield of medical thoracoscopy among the studied patients was 80.6%. The histopathological yield of thoracoscopic pleural biopsies was as follows: 40 (80%) malignant cases, (20%) patients with tuberculous pleuritis. The post-thoracoscopic complications in this study occurred only in nine (25%) patients, which were minor complications in the form of surgical emphysema and prolonged air leak, wound infection, dislodged drain, trapped lung, and pain during the procedure. Conclusion: Medical thoracoscopy is a good diagnostic procedure for pulmonologists to evaluate undiagnosed pleural effusions.