Is There a Role for a Needle Thoracoscopic Pleural Biopsy under Local Anesthesia for Pleural Effusions?.
- Author:
Ho Sung SON
1
;
Sung Ho LEE
;
Laleng Mawia DARLONG
;
Jae Seong JUNG
;
Kyung SUN
;
Kwang Taik KIM
;
Hee Jung KIM
;
Kanghoon LEE
;
Seung Hun LEE
;
Jong Tae LEE
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center, Korea. sholeemd@korea.ac.kr
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Biopsy;
Pleural disease;
Pleural effusion;
Tumor, malignant;
Video-assisted thoracic surgery (VATS)
- MeSH:
Anesthesia, Local*;
Biopsy*;
Humans;
Needles*;
Pleural Diseases;
Pleural Effusion*;
Pneumothorax;
Syncope, Vasovagal;
Thoracoscopy
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2014;47(2):124-128
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: A closed pleural biopsy is commonly performed for diagnosing patients exhibiting pleural effusion if prior thoracentesis is not diagnostic. However, the diagnostic yield of such biopsies is unsatisfactory. Instead, a thoracoscopic pleural biopsy is more useful and less painful. METHODS: We compared the diagnostic yield of needle thoracoscopic pleural biopsy performed under local anesthesia with that of closed pleural biopsy. Sixty-seven patients with pleural effusion were randomized into groups A and B. Group A patients were subjected to closed pleural biopsies, and group B patients were subjected to pleural biopsies performed using needle thoracoscopy under local anesthesia. RESULTS: The diagnostic yields and complication rates of the two groups were compared. The diagnostic yield was 55.6% in group A and 93.5% in group B (p<0.05). Procedure-related complications developed in seven group A patients but not in any group B patients. Of the seven complications, five were pneumothorax and two were vasovagal syncope. CONCLUSION: Needle thoracoscopic pleural biopsy under local anesthesia is a simple and safe procedure that has a high diagnostic yield. This procedure is recommended as a useful diagnostic modality if prior thoracentesis is non-diagnostic.
