Medical thoracoscopy is a new diagnostic technique introduced in a developing country. This technique is minimally invasive and can be performed under conscious sedation and local anesthesia. We were looking upon the infection rates because we are worried that we have a very high rate of infectious diseases and high prevalence of post operative infections. We are also worried about post operative infections with this new procedure, which might be high. We also reviewed looking at the duration of hospital stay, diagnostic accuracy and yield of correct tissue sample for biopsy.
This is a prospective study in which procedures were performed in theater having a sterile environment in tertiary care center in patients with indications of pleural effusion. We looked at the infection rates, amount of analgesia given, and duration of hospital stay along with the rate of accuracy of the procedure in taking the correct tissue sample for biopsy.
Diagnostic procedures were performed in 10 patients and successful in all patients and incidence of infection was 0%. We found there was 100% accuracy in taking out tissue / fluid samples. The diagnosis was T.B (n = 2) , non specific inflamation (n = 4) , Adenocarcinoma metastasis to pleura from unknown source (n = 1), Small cell carcinoma metastasis to pleura from primary lung malignancy (n = 1)Sepsis (n = 2) We used levofloxacillin post operatively for 7 days in all patients prophylactically and the procedures were done in sterile conditions. On an average 4.5 mg of midazolam was used for sedation and average hospital stay was 7 days.
medical thoracoscopy is a very useful technique in unexplained pleural effusions even in countries where post operative complications are high.
It is a useful procedure but does not always lead to specific diagnosis for pleural effusions.It has the advantage that 100% tissue biopsy and sampling can be achieved and so better diagnosis and treatment is possible even in pulmonary TB presenting with pleural effusions.
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