Related Experiment Video
Updated: May 21, 2025

Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
Published on: November 10, 2023
Comparative study between ultrasound-guided closed pleural biopsy and thoracoscopic pleural biopsy in undiagnosed
Sreyas Sharma1, Nitesh Gupta1, Pranav Ish1
1Department of Pulmonary Medicine, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi.
Abstract:
Pleural biopsies are often required to establish a diagnosis in exudative pleural effusions, which remain undiagnosed after initial pleural fluid analysis. Medical thoracoscopy offers a high diagnostic yield but has limited availability in resource-constrained settings. This prospective comparative study evaluated the diagnostic yield between ultrasound-guided closed pleural biopsy and medical thoracoscopy among patients with undiagnosed exudative pleural effusions with pleural-based lesions at least 10 mm in size. Both groups achieved an equal diagnostic yield of 92% despite fewer biopsy specimens being taken in the ultrasound-guided biopsy group (4.52±0.65) compared to the thoracoscopic group (7.8±1) (p<0.0001). In conclusion, ultrasound-guided closed pleural biopsy is a suitable alternative to medical thoracoscopy in patients with undiagnosed exudative pleural effusion having pleural thickening or nodularity of at least 10 mm in size, in terms of having a similar diagnostic yield as compared to medical thoracoscopy.
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