A randomised controlled study to compare the efficacy of closed pleural biopsy and medical thoracoscopic pleural biopsy in undiagnosed exudative pleural effusion

This study was to compare the efficacy of closed pleural biopsy with Abram9s needle and medical thoracoscopic biopsy in the diagnosis of undiagnosed exudative pleural effusion in a tertiary care setting. It was a randomised controlled study during the period Nov.2008- Oct.2010. All patients admitted with pleural effusion, underwent a clinical workup for pleural effusion. Light9s criterion is used to differentiate between exudative and transudative pleural effusion. Those patient9s with exudative pleural effusion without the establishment of a specific diagnosis were included in the study. The enrolled patients were then randomised into 2 groups. One group was subjected to medical thoracoscopic pleural biopsy and the other to closed pleural biopsy with Abrahm9s needle. Demographic, clinical & biochemical charecteristics, diagnostic yield and the complications were of the two groups were compared. 58 patients were included in the study and they were divided into two groups of 29 patients each. The diagnostic yield was 86.2% in the medical thoracoscopy group as compared to 62.1% in closed pleural biopsy group. Complication rate was 10.3% in medical thoracoscopy group compared to 17.2% in closed pleural biopsy group. Hence the study concluded that medical thoracoscopic pleural biopsy had a better diagnostic yield with a lower complication rate as compared to closed pleural biopsy with Abrahm9s needle.