Diagnostic yield of medical thoracoscopy in cases of undiagnosed pleural effusion in Kobri El-Kobba Military Hospital

Recurrent and persistent pleural exudates are common in clinical practice, and in a large number of patients, thoracocentesis and blind pleural biopsy procedures do not provide a definitive diagnosis. In the Western world, the majority of these exudates are malignant. Thoracoscopy today remains the gold standard technique in providing diagnosis and management in these cases. Diagnostic yield of medical thoracoscopy was evaluated in cases of undiagnosed pleural effusion. Semi flexible medical thoracoscopy was done for 40 patients in the period between March 2010 and October 2012 in Kobri El-Kobba Military chest Hospital through double points of entry. Medical thoracoscopy gave a definitive diagnosis in 38 out of 40 patients with diagnostic yield 95%. Malignancy was diagnosed in 28 patients (70%), one patient was diagnosed as empyema (2.5%), tuberculosis was found in 9 patients (22.5%), and it was non diagnostic in 2 patients (5%). The post-thoracoscopic complications in the studied group have occurred only in 4 patients (10%). Medical thoracoscopy is a valuable tool in the diagnosis of undiagnosed exudative pleural effusion. It is a simple and safe method with high diagnostic yield and with low complication rates.