Role of Medical Thoracoscopy in Undiagnosed Exudative Pleural Effusion

Abstract

Pleural effusion is one of the commonest disease entities seen by the pulmonologists. Pleural effusion can occur as a complication of many different diseases. The vigor with which various diagnoses are pursued depends on the likelihood that the individual has that particular disease. Options available for pleural fluid–negative disease are limited to blind pleural biopsy (non-image guided) using Abram's or Cope's needle, image-guided pleural biopsy (ultrasonography or computed tomography-guided), surgical thoracotomy and finally thoracoscopy. A variety of diagnostic and therapeutic indications for medical thoracoscopy are usually adopted e.g. pleural effusion of unknown origin, suspected tuberculous pleuritis, suspected malignancy and recurrent pleural effusion requiring pleurodesis. For expert pulmonologists, advanced procedures in medical thoracoscopy are the non-routine and complex applications of the method.