Procedures: Procedures: Pleura |

Diagnostic and Therapeutic Outcome of Medical Thoracoscopy in India FREE TO VIEW

Binu Krishnan, MD
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PRS Hospital, Trivandrum, India

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A436. doi:10.1016/j.chest.2016.02.454
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SESSION TITLE: Procedures: Pleura

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: Though medical thoracoscopy is widely used globally, there are only a few centres in India performing this procedure. The objective of this study is to determine the diagnostic and therapeutic outcome of medical thoracoscopy in a tertiary care centre in India.

METHODS: Retrospective analysis of all thoracoscopies done from May 2010 to Jan 2014 (45 months) in our centre.

RESULTS: During this period, 87 medical thoracoscopic procedures were performed. Of these, 76 were diagnostic and 11 therapeutic. Mean age was 56.1 years for diagnostic and 61.3 for therapeutic indications. Main diagnostic indications were undiagnosed effusions (82.9%), empyema (7.9%) and recurrent pneumothorax (2.6%). Histopathology reports showed tuberculosis as the most common diagnosis (42.1%), followed by malignancy (39.5%) and chronic inflammation (7.9%). Rare diagnosis includes haemangioma of the lung. Therapeutic pleurodesis with talc (via thoracoscope) was done in 11 patients. Major indication was malignant pleural effusion (81.9%). Follow-up chest x-ray after one month showed no recurrence, indicating complete success.

CONCLUSIONS: The major cause of recurrent effusion in India is tuberculosis, closely followed by malignancy. This is in contrast to many of the western literature which identifies malignancy as the most common cause. Though sample size is small, our data shows that success rate is very high for thoracoscopic talc pleurodesis.

CLINICAL IMPLICATIONS: Medical Thoracoscopy should be widely practised for exudative pleural effusions in India so that a definitve diagnosis of tuberculosis or malignancy can be made. This also helps to avoid the practice of strarting empirical anti- Tb medications without a proper diagnosis.

DISCLOSURE: The following authors have nothing to disclose: Binu Krishnan

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