title: The role of thoracoscopy in the evaluation and management of pleural effusions.
abstract: Diagnostic thoracoscopy is indicated in every patient where the usual investigations (including biochemistry, cytology, bacteriology, occasionally needle biopsy of the pleura) do not achieve a precise diagnosis. The percentage of so-called "idiopathic" effusions, amounting to approximately 20% in many published series, can be reduced to 4% after thoracoscopy. The sensibility of thoracoscopic biopsy reaches 93-97% of malignant or tuberculous pleural effusions. The procedure requires a short hospitalization of about 36 hr, and complications are rare. Therapeutic thoracoscopy is frequently performed in chronic, malignant, recurrent effusions in order to achieve a pleurodesis by means of a talc poudrage under visual control. The efficacy of the poudrage in the published randomized studies is better than tetracycline. About 90% of patients are cured, the effusion being totally suppressed. Side effects are rare if the quantity of talc does not exceed 10 ml.
authors.affiliation: Hôpital la Conception, Marseille, France.
authors.forename: C
authors.initials: C
authors.lastname: Boutin
authors.forename: P
authors.initials: P
authors.lastname: Astoul
authors.forename: B
authors.initials: B
authors.lastname: Seitz
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D010994:Pleura / Q000473:pathology; D010996:Pleural Effusion / Q000209:etiology* / Q000628:therapy; D010997:Pleural Neoplasms / Q000473:pathology; D010998:Pleurisy / Q000473:pathology; D013906:Thoracoscopy / Q000379:methods*; D014396:Tuberculosis, Pleural / Q000473:pathology