0
Original Research: Pulmonary Procedures |

Diagnostic Accuracy and Safety of Semirigid Thoracoscopy in Exudative Pleural EffusionsSemirigid Thoracoscopy in Pleural Effusions: A Meta-analysis

Ritesh Agarwal, MD, FCCP; Ashutosh N. Aggarwal, MD, FCCP; Dheeraj Gupta, MD, FCCP
Author and Funding Information

From the Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Correspondence to: Ritesh Agarwal, MD, FCCP, Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Sector-12, Chandigarh-160012, India; e-mail: riteshpgi@gmail.com


Funding/Support: The authors have reported to CHEST that no funding was received for this study.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;144(6):1857-1867. doi:10.1378/chest.13-1187
Text Size: A A A
Published online

Background:  The usefulness of semirigid thoracoscopy in undiagnosed exudative pleural effusions (EPEs) has been variably reported in different studies. Herein, we perform a systematic review and meta-analysis to estimate the overall diagnostic yield and safety of semirigid thoracoscopy in EPE.

Methods:  We searched the PubMed and EMBASE databases for studies reporting the outcomes of semirigid thoracoscopy in EPE. The quality of studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. The yield of semirigid thoracoscopy was analyzed by calculating the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic OR (DOR) for each study and pooling the study results using a random effects model. Heterogeneity and publication bias were assessed for individual outcomes. Sensitivity analysis was performed to explore the potential causes of heterogeneity.

Results:  Our search yielded 17 studies (755 patients with undiagnosed EPE). The sensitivity, specificity, PLR, NLR, and DOR of semirigid thoracoscopy was 91%, 100%, 4.92, 0.08, and 102.28, respectively. The area under the curve for the summary receiver operating characteristic curve was 0.93. There were negligible complications and no mortality. There was evidence of heterogeneity, which significantly decreased on sensitivity analysis after exclusion of smaller (< 25 participants) studies. There was no evidence of publication bias.

Conclusions:  Semirigid thoracoscopy is an efficacious and safe procedure in diagnosis of EPE. Because of the small sample size, larger well-designed trials are required to confirm the results of this study. There is also a need for head-to-head comparison of semirigid and rigid thoracoscopy.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543