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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Article
Author(s)
Bhavya Atul Shah1, Mahendra Singh Raghuvanshi1, Tapan Surana1, Navedeep Labana1, Mohammad Zeeshan Mansuri1 and H. G. Varudkar2
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DOI:10.17265/2328-7136/2018.04.009
Affiliation(s)
1. Post Graduate Resident
2. Professor and Head, Department of Pulmonary Medicine, R.D. Gardi Medical College, Ujjain 456006, India
ABSTRACT
Background and Aims: Since our rural institution
has limited resources we always choose economical options. Recently, indigenous
technique of pleuroscopy is gaining popularity due to various advantages. We
developed indigenous technique of medical thoracoscopy has been developed and
done by using set of patented conduits and fiberoptic bronchoscope (FOB).Therefore, we have used
this technique for undiagnosed pleural effusions. Methods: An observational study
was conducted in 79 undiagnosed cases of exudative pleural effusion from June 2016
to January 2017. Indigenous technique consists of use of fiber optic bronchoscope through various metallic conduits to
be used in specified order for medical thoracoscopy. Procedure is done under conscious
sedation and conduits are passed one after another in a specified order, through
the chest stoma. The visualization of pleural cavity and various procedures were
done with FOB (fiberoptic
bronchoscope). Results: Out of the 79 cases, the appearance of pleura showed, inflamed/reddened pleura
in 16 (20.2%) cases, thin transparent
adhesions in 18 (22.7%), thin transparent
loculations in 16 (20.2%) cases, thick loculations
in 6 (7.6%) cases, hard pleural
surface in 5 (6.3%), large nodule/masses
in 6 (7.6%), small milliary
seedlings or sago grain appearance in 6 (7.6%), scattered masses or nodules in 5 (6.3%) and, broncho-pleural fistula was observed in 1 (1.2%) case. Histopathological
analysis showed chronic inflammation in 34.1% (27), tubercular lesions in 24.05%
(19) of patients. Primary aspergillosis and mesothelioma each has 1 case, and the rest 29.11
% (23) were pleural metastasis. Thus, diagnostic yield of pleuroscopy pleural biopsy
was 89.9% (71). Conclusion: Indigenous technique appears to be an efficient and relatively safe procedure with good
diagnostic yield in undiagnosed pleural effusions.
KEYWORDS
Pleural effusion, pleuroscopy, thoracoscopy, indigenous technique, diagnostic utility, fiberoptic bronchoscope.
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