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Abstract：
BACKGROUND: Pleural effusion is a medical condition where an excessive amount of fluid accumulates in the pleural space. This can be caused by inflammation or malignant growth in the body. Doctors use medical thoracoscopy for both diagnostic and therapeutic purposes. This technique allows them to view the internal pleural surfaces and take biopsies of any abnormal lesions within the pleural cavity.
OBJECTIVE: This work aimed to evaluate the diagnostic value of pleuroscopy in patients with undiagnosed exudative pleural effusion.
METHODS: A study was conducted on 61 patients who had undiagnosed exudative pleural effusion and were admitted to the chest department at the cardiothoracic unit of the Minia University Hospital. All patients provided written consent and underwent a complete history and clinical examination. Standard laboratory tests, including routine liver and kidney function tests, a complete blood count, and a coagulation profile, were conducted on all patients, along with chest X-rays. If necessary, a chest CT scan was also performed. Diagnostic thoracentesis was done, and the pleural fluid was analyzed for sugar, protein, and lactate dehydrogenase and sent for bacteriological analysis (Gram stain, culture, and acid-fast bacilli smear) and cytopathological examination. Medical thoracoscopy was performed in cases where an etiological diagnosis was not established.
RESULTS: A total of 61 patients with undiagnosed exudative pleural effusions were included. A definitive etiological diagnosis was reached in 58 (95%) patients. In 47 (77%) of the studied group, malignant etiology was confirmed; nine (14.8%) had tuberculous pleurisy, one (1.6%) had empyema, and one (1.6%) had inflammatory/autoimmune pleurisy. A definite diagnosis was not reached in three (5%) patients. The malignant pathology was caused by bronchogenic carcinoma in 20 (42.5%) cases, malignant mesothelioma in 10 (21.3%) cases, metastatic malignant deposits from other organs in six (12.7%) cases, and lymphoma in three (6.5%) cases. No serious adverse events related to the procedure were recorded. The most common minor complications were transient chest pain in 34 (55.7%) patients, followed by surgical emphysema in 10 (16.4%) patients.
CONCLUSIONS: Pleuroscopy is an effective diagnostic tool for identifying the cause of pleural effusion when it is unclear. It is a minimally invasive and straightforward procedure associated with high diagnostic accuracy and low complication rates.
OBJECTIVE: This work aimed to evaluate the diagnostic value of pleuroscopy in patients with undiagnosed exudative pleural effusion.
METHODS: A study was conducted on 61 patients who had undiagnosed exudative pleural effusion and were admitted to the chest department at the cardiothoracic unit of the Minia University Hospital. All patients provided written consent and underwent a complete history and clinical examination. Standard laboratory tests, including routine liver and kidney function tests, a complete blood count, and a coagulation profile, were conducted on all patients, along with chest X-rays. If necessary, a chest CT scan was also performed. Diagnostic thoracentesis was done, and the pleural fluid was analyzed for sugar, protein, and lactate dehydrogenase and sent for bacteriological analysis (Gram stain, culture, and acid-fast bacilli smear) and cytopathological examination. Medical thoracoscopy was performed in cases where an etiological diagnosis was not established.
RESULTS: A total of 61 patients with undiagnosed exudative pleural effusions were included. A definitive etiological diagnosis was reached in 58 (95%) patients. In 47 (77%) of the studied group, malignant etiology was confirmed; nine (14.8%) had tuberculous pleurisy, one (1.6%) had empyema, and one (1.6%) had inflammatory/autoimmune pleurisy. A definite diagnosis was not reached in three (5%) patients. The malignant pathology was caused by bronchogenic carcinoma in 20 (42.5%) cases, malignant mesothelioma in 10 (21.3%) cases, metastatic malignant deposits from other organs in six (12.7%) cases, and lymphoma in three (6.5%) cases. No serious adverse events related to the procedure were recorded. The most common minor complications were transient chest pain in 34 (55.7%) patients, followed by surgical emphysema in 10 (16.4%) patients.
CONCLUSIONS: Pleuroscopy is an effective diagnostic tool for identifying the cause of pleural effusion when it is unclear. It is a minimally invasive and straightforward procedure associated with high diagnostic accuracy and low complication rates.
摘要：
背景：胸腔积液是一种医学状况，其中过量的液体积聚在胸膜腔中。这可能是由体内炎症或恶性生长引起的。医生将医用胸腔镜用于诊断和治疗目的。这种技术使他们能够观察胸膜内部表面并对胸膜腔内的任何异常病变进行活检。
目的：本研究旨在评价胸腔镜检查对未确诊的渗出性胸腔积液的诊断价值。
方法：对61例未确诊的渗出性胸腔积液患者进行了一项研究，这些患者被送往Minia大学医院心胸病房的胸科。所有患者均提供书面同意，并接受了完整的病史和临床检查。标准实验室测试，包括常规肝肾功能检查,全血细胞计数,和凝血曲线，对所有患者进行了检查，还有胸部X光片.如有必要,还进行了胸部CT扫描.做了诊断性胸腔穿刺术,对胸膜液进行糖分析,蛋白质，和乳酸脱氢酶，并送去细菌学分析(革兰氏染色，文化,和抗酸杆菌涂片）和细胞病理学检查。在未确定病因诊断的情况下进行了医学胸腔镜检查。
结果：共纳入61例未确诊的渗出性胸腔积液患者。58例（95％）患者获得了明确的病因诊断。在研究组的47名（77%）中，恶性病因得到证实；9人（14.8%）患有结核性胸膜炎，其中一人(1.6%)患有脓胸，1人(1.6%)患有炎性/自身免疫性胸膜炎。三名（5％）患者未获得明确诊断。20例(42.5%)由支气管肺癌引起的恶性病理。恶性间皮瘤10例（21.3%），6例（12.7%）来自其他器官的转移性恶性沉积物，3例（6.5%）淋巴瘤。没有记录到与该程序相关的严重不良事件。最常见的轻微并发症是34例（55.7%）患者的一过性胸痛，其次是10例(16.4%)患者的外科肺气肿。
结论：胸膜镜检查是确定胸腔积液病因的有效诊断工具。这是一种微创和简单的程序，具有高诊断准确性和低并发症发生率。
目的：本研究旨在评价胸腔镜检查对未确诊的渗出性胸腔积液的诊断价值。
方法：对61例未确诊的渗出性胸腔积液患者进行了一项研究，这些患者被送往Minia大学医院心胸病房的胸科。所有患者均提供书面同意，并接受了完整的病史和临床检查。标准实验室测试，包括常规肝肾功能检查,全血细胞计数,和凝血曲线，对所有患者进行了检查，还有胸部X光片.如有必要,还进行了胸部CT扫描.做了诊断性胸腔穿刺术,对胸膜液进行糖分析,蛋白质，和乳酸脱氢酶，并送去细菌学分析(革兰氏染色，文化,和抗酸杆菌涂片）和细胞病理学检查。在未确定病因诊断的情况下进行了医学胸腔镜检查。
结果：共纳入61例未确诊的渗出性胸腔积液患者。58例（95％）患者获得了明确的病因诊断。在研究组的47名（77%）中，恶性病因得到证实；9人（14.8%）患有结核性胸膜炎，其中一人(1.6%)患有脓胸，1人(1.6%)患有炎性/自身免疫性胸膜炎。三名（5％）患者未获得明确诊断。20例(42.5%)由支气管肺癌引起的恶性病理。恶性间皮瘤10例（21.3%），6例（12.7%）来自其他器官的转移性恶性沉积物，3例（6.5%）淋巴瘤。没有记录到与该程序相关的严重不良事件。最常见的轻微并发症是34例（55.7%）患者的一过性胸痛，其次是10例(16.4%)患者的外科肺气肿。
结论：胸膜镜检查是确定胸腔积液病因的有效诊断工具。这是一种微创和简单的程序，具有高诊断准确性和低并发症发生率。
