Medical thoracoscopy: Analysis on diagnostic yield through 30 years of experience

Medical thoracoscopy (MT) or pleuroscopy is a procedure performed to diagnose and treat malignant and benign pleural diseases. Totally 2752 pleuroscopies executed in 1984-2013 in our center were considered in this study.

A retrospective observational study was performed. Observational time was divided into six series of 5 years. We calculated MT diagnostic yield and analyzed trends of main diseases diagnosed along the time.

Along the 30 years population became progressively older. Number of pleuroscopies firstly increased, then stabilized and decreased in the last 5 years. The overall diagnostic yield of MT was 71%, increasing from 57% to 79%. The diagnostic yield was significantly higher in the presence of monolateral pleural effusion. Cancer represented more than half of diagnosis; tuberculosis was the most common nonneoplastic disease. The frequency of all cancers, mesothelioma, and lung cancer increased through the time; tuberculosis first decreased and then increased. All specimens resulted appropriate during the last 25 years.

MT has a great diagnostic yield that can be improved by practice, permitting to achieve a specific histological diagnosis in about 80% of patients. Our experience demonstrates that the accurate selection of the patients undergoing to MT is very important to reach these results.