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The role of thoracoscopy in the evaluation and management of pleural effusions

  • Endoscopy, Biopsy Techniques In Pleural Diseases
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Abstract

Diagnostic thoracoscopy is indicated in every patient where the usual investigations (including biochemistry, cytology, bacteriology, occasionally needle biopsy of the pleura) do not achieve a precise diagnosis. The percentage of so-called “idiopathic” effusions, amounting to approximately 20% in many published series, can be reduced to 4% after thoracoscopy. The sensibility of thoracoscopic biopsy reaches 93–97% of malignant or tuberculous pleural effusions. The procedure requires a short hospitalization of about 36 hr, and complications are rare.

Therapeutic thoracoscopy is frequently performed in chronic, malignant, recurrent effusions in order to achieve a pleurodesis by means of a talc poudrage under visual control. The efficacy of the poudrage in the published randomized studies is better than tetracycline. About 90% of patients are cured, the effusion being totally suppressed. Side effects are rare if the quantity of talc does not exceed 10 ml.

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Authors and Affiliations

  1. Hôpital la Conception, 147 Boulevard Baille, 13386, Marseille Cedex 5, France

    C. Boutin, Ph. Astoul & B. Seitz

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  1. C. Boutin
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  2. Ph. Astoul
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  3. B. Seitz
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Boutin, C., Astoul, P. & Seitz, B. The role of thoracoscopy in the evaluation and management of pleural effusions. Lung 168 (Suppl 1), 1113–1121 (1990). https://doi.org/10.1007/BF02718251

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