Frequency of Malignancy on Video-Assisted Thoracoscopic Pleural Biopsy in Patients with Exudative Pleural Effusion
DOI:
https://doi.org/10.51253/pafmj.v74i6.11275Keywords:
Exudative Pleural Effusion, Malignancy, Pleural Biopsy, Tuberculosis, VATS.Abstract
Objective: To identify the frequency of malignancy upon Video-assisted thoracoscopic pleural biopsy in patients with exudative pleural effusion.
Study Design: Retrospective longitudinal study.
Place and Duration of Study: Thoracic Surgery Department, CMH Rawalpindi, Pakistan from Jan 2022 to Aug 2023.
Methodology: The study included 273 patients having exudative pleural effusion diagnosed upon pleural tap. Patients who had negative cytology and mycobacterial cultures were included in the study. The previous diagnostic procedures, histopathology, along with culture reports, were collected for all patients. Any additional procedures and complications of VATS were also documented in the patients.
Results: Of 273 patients, 183(67.03%) male and 90(32.96%) females. VATS pleural biopsy revealed cancer in 81(29.67%) patients. Lung cancer was the most frequent malignancy, accounting for 49(17.94%) cases. Mesothelioma was found in 11(4.02%) cases, metastatic carcinoma in 21(7.69%) cases. 128(46.88%) were proven to have tuberculosis, non-specific inflammation was diagnosed in 64(23.44%) cases. VATS-related complications occurred in 34(12.45%) patients. No mortality was observed within 30 days of admission.
Conclusion: The diagnosis of exudative pleural effusions can be safely and efficiently made by VATS pleural biopsy. The most prevalent diagnosis in our setup was pulmonary tuberculosis, followed by malignancies.
Downloads
References
Jany B, Welte T. Pleural Effusion in Adults-Etiology, Diagnosis, and Treatment. Dtsch Arztebl Int 2019; 116(21): 377-386.
https://doi.org/10.3238/arztebl.2019.0377
Na MJ. Diagnostic tools of pleural effusion. Tuberc Respir Dis 2014; 76(5): 199-210. https://doi.org/10.4046/trd.2014.76.5.199
Porcel JM, Diaz JP, Dennis S. Clinical implications of pleural effusions in ovarian cancer. Respirology 2012 ;17(7): 1060-1067.
Böhm E. Cause of Asbestos-Induced Pleurisy Forgotten. Dtsch Arztebl Int 2019; 116(37): 615.
https://doi.org/10.3238/arztebl.2019.0615a
Ryu JS, Ryu HJ, Lee SN, Memon A, Lee SK, Nam HS, et al. Prognostic impact of minimal pleural effusion in non-small-cell lung cancer. J Clin Oncol 2014; 32(9): 960-967.
https://doi.org/10.1200/JCO.2013.50.5453
Bhattacharya S, Bairagya TD, Das A, Mandal A, Das SK. Closed pleural biopsy is still useful in the evaluation of malignant pleural effusion. J Lab Physicians 2012; 4(1): 35-38.
https://doi.org/10.4103/0974-2727.98669
Paliouras D, Barbetakis N, Lazaridis G, Baka S, Mpoukovinas I, Karavasilis V, et al. Video-assisted thoracic surgery and pneumothorax. J Thorac Dis 2015; 7(Suppl 1): S56-61. https://doi.org/10.3978/j.issn.2072-1439.2015.01.35
Reinersman JM, Passera E, Rocco G. Overview of uniportal video-assisted thoracic surgery (VATS): past and present. Ann Cardiothorac Surg 2016; 5(2): 112-117.
https://doi.org/10.21037/acs.2016.03.08
Koizumi K, Haraguchi S, Hirata T, Hirai K, Mikami I, Kubokura H, et al. Thoracoscopic surgery in children. J Nippon Med Sch 2005; 72(1): 34-42. https://doi.org/10.1272/jnms.72.34
Lortholary O, Gangneux JP, Sitbon K, Lebeau B, de Monbrison F, Le Strat Y, et al; French Mycosis Study Group. Epidemiological trends in invasive aspergillosis in France: the SAIF network (2005-2007). Clin Microbiol Infect 2011; 17(12): 1882-1889. https://doi.org/10.1111/j.1469-0691.2011.03548.x
Cohen LA, Light RW. Tuberculous Pleural Effusion. Turk Thorac J 2015; 16(1): 1-9. https://doi.org/10.5152/ttd.2014.001
Abdulelah M, Abu Hishmeh M. Infective Pleural Effusions-A Comprehensive Narrative Review Article. Clin Pract 2024; 14(3): 870-881. https://doi.org/10.3390/clinpract14030068
Shang-Gin Wu, Chong-Jen Yu, Meng-Feng Tsai, Wei-Yu Liao, Chih-Hsin Yang, I-Shiow Jan, Pan-Chyr Yang, Jin-Yuan Shih, Survival of lung adenocarcinoma patients with malignant pleural effusion, Eur Respir J 2013; 41: 1409-1418.
https://doi.org/10.1183/09031936.00069812
Tanase BC, Burlacu AI, Nistor CE, Horvat T, Oancea C, Marc M, et al. A Retrospective Analysis Comparing VATS Cost Discrepancies and Outcomes in Primary Lung Cancer vs. Second Primary Lung Cancer Patients. Healthcare 2023; 11(12): 1745. https://doi.org/10.3390/healthcare11121745
Gonzalez-Rivas D, Garcia A, Chen C, Yang Y, Jiang L, Sekhniaidze D, et al. Technical aspects of uniportal video-assisted thoracoscopic double sleeve bronchovascular resections. Eur J Cardiothorac Surg 2020; 58(Suppl_1): i14-i22.
https://doi.org/10.1093/ejcts/ezaa037
Verma A, Taha A, Venkateswaran S, Tee A. Effectiveness of medical thoracoscopy and thoracoscopic talc poudrage in patients with exudative pleural effusion. Singapore Med J 2015; 56(5): 268-273. https://doi.org/10.11622/smedj.2015075
Skok K, Hladnik G, Grm A, Crnjac A. Malignant Pleural Effusion and Its Current Management: A Review. Medicina 2019; 55(8): 490. https://doi.org/10.3390/medicina55080490
Heffner JE, Klein JS. Recent advances in the diagnosis and management of malignant pleural effusions. Mayo Clin Proc 2008; 83(2): 235-250. https://doi.org/10.4065/83.2.235
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Farhan Ullah, Farhan Ahmed Majeed , Bilal Umair, Muhib Ullah, Jawad, Warda Farhan
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
