Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Is There a Role for a Needle Thoracoscopic Pleural Biopsy under Local Anesthesia for Pleural Effusions?

  • Son, Ho Sung (Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center) ;
  • Lee, Sung Ho (Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center) ;
  • Darlong, Laleng Mawia (Thoracic Surgery & Thoracic Surgical Oncology Clinic, Fortis-Hospital) ;
  • Jung, Jae Seong (Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center) ;
  • Sun, Kyung (Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center) ;
  • Kim, Kwang Taik (Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center) ;
  • Kim, Hee Jung (Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center) ;
  • Lee, Kanghoon (Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center) ;
  • Lee, Seung Hun (Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center) ;
  • Lee, Jong Tae (Korea Artificial Organ Center, Korea University)
  • Received : 2013.08.08
  • Accepted : 2013.10.15
  • Published : 2014.04.05
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Abstract

Background: A closed pleural biopsy is commonly performed for diagnosing patients exhibiting pleural effusion if prior thoracentesis is not diagnostic. However, the diagnostic yield of such biopsies is unsatisfactory. Instead, a thoracoscopic pleural biopsy is more useful and less painful. Methods: We compared the diagnostic yield of needle thoracoscopic pleural biopsy performed under local anesthesia with that of closed pleural biopsy. Sixty-seven patients with pleural effusion were randomized into groups A and B. Group A patients were subjected to closed pleural biopsies, and group B patients were subjected to pleural biopsies performed using needle thoracoscopy under local anesthesia. Results: The diagnostic yields and complication rates of the two groups were compared. The diagnostic yield was 55.6% in group A and 93.5% in group B (p<0.05). Procedure-related complications developed in seven group A patients but not in any group B patients. Of the seven complications, five were pneumothorax and two were vasovagal syncope. Conclusion: Needle thoracoscopic pleural biopsy under local anesthesia is a simple and safe procedure that has a high diagnostic yield. This procedure is recommended as a useful diagnostic modality if prior thoracentesis is non-diagnostic.

Keywords

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