To Study Diagnostic Value of Thoracoscopy in Undiagnosed Cases of Exudative Pleural Effusion

Background and Aims: Undiagnosed exudative pleural effusions were defined as pleural effusions in which an aetiological diagnosis could not be ascertained by initial pleural fluid analysis. Between 25% and 30% of pleural effusions may remain undiagnosed despite a combination of pleural fluid analysis and closed pleural biopsy. Medical thoracoscopy may assist physicians in diagnosing such cases. Aims and Objectives: This study aims to study the diagnostic utility of medical thoracoscopy in undiagnosed pleural effusions. Materials and Methods: This is an observational prospective, hospital-based study conducted on 40 patients at the Government Hospital for Chest and Communicable Diseases, Department of Pulmonary Medicine, Andhra Medical College, Visakhapatnam, from January 2024 to December 2024. The study was carried out after obtaining institutional ethics clearance and informed written consent from the participants. Results: Thoracoscopy was performed in 40 patients, of whom 29 were male and 11 were female. The indication for thoracoscopy in all these patients was inconclusive initial pleural fluid analysis. Of the 40 cases, 17 were diagnosed as malignant and 23 as non-malignant. Of the 23 non-malignant cases, 15 were diagnosed as tuberculosis. Conclusion: Based on our results, we conclude that, given its high diagnostic yield and acceptable safety profile, rigid thoracoscopy should be considered in the evaluation of exudative pleural effusion when pleural fluid analysis is inconclusive.