title: Medical thoracoscopy: a useful diagnostic tool for undiagnosed pleural effusion.
abstract: OBJECTIVE
  We aimed to assess the role of medical thoracoscopy in patients with undiagnosed pleural effusion.
  
  
  METHODS
  Patiens presenting with pleural effusion underwent three pleural aspirations. Patients in whom pleural fluid analysis was inconclusive underwent closed pleural biopsy for diagnostic confirmation. Patients in whom closed pleural biopsy was incolcusive underwent medical thoracoscopy using a rigid thoracoscope with a viewing angle of zero degrees was done under local anaesthesia and sedation with the patient lying in lateral decubitus position with the affected side up. Biopsy specimens from parietal pleura were obtained under direct vision and were sent for histopathological examination.
  
  
  RESULTS
  Of the 128 patients with pleural effusion who were studied, pleural fluid examination established the diagnosis in 81 (malignancy 33, tuberculosis 33, pyogenic 14 and fungal 1); 47 patients underwent closed pleural biopsy and a diagnosis was made in 28 patients (malignancy 24, tuberculosis 4). The remaining 19 patients underwent medical thoracoscopy and pleural biopsy and the aetiological diagnosis could be confirmed in 13 of the 19 patients (69%) (adenocarcinoma 10, poorly differentiated carcinoma 2 and mesothelioma 1).
  
  
  CONCLUSIONS
  Medical thoracoscopy is a useful tool for the diagnosis of pleural diseases. The procedure is safe with minimal complications.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Agarwal
authors.forename: Rajendra
authors.initials: R
authors.lastname: Prasad
authors.forename: Rajiv
authors.initials: R
authors.lastname: Garg
authors.forename: S K
authors.initials: SK
authors.lastname: Verma
authors.forename: Abhijeet
authors.initials: A
authors.lastname: Singh
authors.forename: N
authors.initials: N
authors.lastname: Husain
mesh_terms: D000328:Adult; D001707:Biopsy, Needle; D003951:Diagnostic Errors / Q000517:prevention & control*; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010994:Pleura / Q000473:pathology*; D010995:Pleural Diseases / Q000145:classification / Q000150:complications / Q000175:diagnosis*; D010996:Pleural Effusion / Q000175:diagnosis* / Q000209:etiology; D011446:Prospective Studies; D015203:Reproducibility of Results; D013906:Thoracoscopy / Q000379:methods*