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Updated: Aug 24, 2026

Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
Published on: November 10, 2023
[Video-assisted thoracoscopic surgery in diagnosis and treatment of pleuritis]
Dainius Amerigas Piscikas1, Saulius Cicenas, Algirdas Jackevicius
1Institute of Oncology, Vilnius University, Santariskiu 1, 2021 Vilnius, Lithuania. vuoipiscikas@yahoo.com
Objective:
To evaluate possibilites of video-assisted thoracoscopic surgery in diagnosis and treatment of pleuritis. 1997-2002 in Department of Thoracic Surgery and Oncology of Vilnius University Institute of Oncology 206 patients underwent videothoracoscopic procedures (146 (70.8%) of them for pleuritis). All procedures were performed in general anesthesia using double lumen tube. Mean patient age was 61+/-10 years. One hundred three women (71%) and 43 men (29%) were operated. Seventy four (51%) chemopleurodesis was performed with pleural biopsies: for 2 patients (1.36%) bleocine was used, and for 74 patients (50.6%) sterile talk.
Results:
Significance of pleural videobiopsies reaches 93%. Eleven patients (7%) failed in diagnosis: in 5 cases (3.4 %) due to adhesions, in 6 cases (3.4%) we made false positive diagnosis.
Complications:
postoperative pneumonia - 12 patients (8.8%), pneumothorax - 2 patients (1.5%), pleural empiema - 1 patient (0.75%), bleeding - 1 patient (0.75%).
Conclusions:
Specificity of video-assisted thoracoscopic surgery in pleural diseases reaches 93.0%. Video-assisted thoracoscopic surgery is necessary even in cases of failed "blind" biopsies and possible in elderly patients. Video-assisted thoracoscopic surgery provides not only easy morphologic verification of pleural diseases but also performance of chemopleurodesis.
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