DIAGNOSTIC YIELD OF MEDICAL THORACOSCOPIC PLEURAL LAVAGE AND BIOPSY IN UNDIAGNOSED EXUDATIVE PLEURAL EFFUSION”

Thoracoscopy is a minimally invasive procedure that allows visualization of the pleural space and intrathoracic structures. It aids in obtaining pleural biopsies under direct vision, therapeutic drainage of effusions and pleural lavage in a single procedure. Pleural effusions despite being a common entity in pulmonary medicine, nearly a quarter of exudative pleural effusions still go undiagnosed despite the initial biochemical and cytological examinations. Medical thoracoscopy is considered a technological boon in diagnosing such scenarios. We aimed to evaluate the diagnostic yield of medical thoracoscopic pleural lavage and biopsy in undiagnosed exudative pleural effusion. Among the 30 patients with undiagnosed exudative pleural effusion which we came across, medical thoracoscopic evaluation was done and yielded a diagnosis in 29 patients with a diagnostic yield of 97%. Pleural lavage was found to have a diagnostic yield of 60% with a sensitivity and specificity of 60% and 100% respectively. This study propounds medical thoracoscopic pleural lavage and biopsy to be an effective and safe procedure in establishing an accurate and timely diagnosis with high yield in patients with undiagnosed exudative pleural effusion.