Is There a Role for a Needle Thoracoscopic Pleural Biopsy under Local Anesthesia for Pleural Effusions?
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.


CONCLUSIONS
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.
Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center, Korea.
Ho Sung
HS
Son
Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center, Korea.
Sung Ho
SH
Lee
Thoracic Surgery & Thoracic Surgical Oncology Clinic, Fortis-Hospital, Korea.
Laleng Mawia
LM
Darlong
Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center, Korea.
Jae Seong
JS
Jung
Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center, Korea.
Kyung
K
Sun
Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center, Korea.
Kwang Taik
KT
Kim
Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center, Korea.
Hee Jung
HJ
Kim
Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center, Korea.
Kanghoon
K
Lee
Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center, Korea.
Seung Hun
SH
Lee
Korea Artificial Organ Center, Korea University, Korea.
Jong Tae
JT
Lee
Biopsy; Pleural disease; Pleural effusion; Tumor, malignant; Video-assisted thoracic surgery (VATS)