医学
胸腔镜检查
胸腔积液
病因学
外科
随机对照试验
活检
肺结核
放射科
内科学
病理
作者
Sunil Kumar,Dipti Gothi,Umesh Chandra Ojha,Nipun Malhotra,Rahul Kumar,Anshul Jain,Mahismita Patro,Divya Goyal,Ram Babu Sah
标识
DOI:10.1016/j.ijtb.2023.09.004
摘要
Medical thoracoscopy (MT) has gained widespread acceptance in the diagnosis of undiagnosed exudative pleural effusions. In developing countries, including India medical thoracoscopy is not widely available. 1. To analyze the yield of closed pleural biopsy (CPB) in comparison with MT in the diagnosis of undiagnosed exudative pleural effusions. 2. Comparison of complications between CPB and MT. This was a prospective randomized controlled study conducted in a tertiary care centre, from January 2020 to September 2021. The patients with undiagnosed exudative pleural effusions were included in the study. The enrolled patients were randomized into two groups, group A and group B. Total of 38 patients were taken, 19 patients in each group. Group A was subjected to MT. Group B was subjected to CPB with cope's needle. Ultrasound was used to mark the site of pleural effusion. Diagnostic yield was 78.9% in both MT and CPB group. CPB was significantly less painful procedure compared to MT. The duration of hospital stay was also significantly less in CPB as compared to MT (P < 0.001). CPB was associated with 5.3% mortality and there was no mortality in MT group. Our study recommends that, in the era of medical thoracoscopy, closed pleural biopsy still holds a significant role in the diagnosis of undiagnosed exudative pleural effusions especially where prevalence of tuberculosis is high. It is also a cost effective approach in developing countries like India.
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