Diagnostic Efficacy of Thoracoscopy in Recurrent Undiagnosed Pleural Effusion

Abstract

Background: Pleural effusion is a common clinical problem with diverse etiologies. Despite initial investigations, a subset of patients presents with recurrent undiagnosed pleural effusions, posing diagnostic challenges. Thoracoscopy offers direct visualization of the pleural cavity and the opportunity to obtain targeted biopsies.

Aims & Objective: To evaluate the diagnostic efficacy of thoracoscopy in patients with recurrent undiagnosed pleural effusion.

Methods: This prospective study included 60 patients with recurrent pleural effusions where prior cytological and biochemical analyses failed to establish a diagnosis. All patients underwent medical thoracoscopy under local anesthesia. Diagnostic yield, safety profile, and histopathological results were analyzed.

Results: Thoracoscopy provided a definitive diagnosis in 54 of 60 patients (90%). Diagnoses included malignancy (65%), tuberculosis (20%), and other inflammatory or benign conditions (5%). The procedure was well tolerated with minor complications in 8% of cases.

Conclusion: Thoracoscopy is a safe and highly effective diagnostic modality for recurrent undiagnosed pleural effusions, significantly improving diagnostic accuracy and guiding appropriate management.

Keywords: Thoracoscopy, Undiagnosed Pleural Effusion, diagnostic accuracy