Role of Medical Thoracoscopy in the evaluation of Pleural Effusion

Pleural effusion is the pathological accumulation of fluid in the pleural space surrounding the lungs and is associated with a wide variety of diseases such as bacterial pneumonia, congestive heart disease, and malignancies. Undiagnosed pleural effusion is defined as the inability to make an accurate etiologic diagnosis following an initial microscopic and biochemical examination of the pleural fluid. Medical thoracoscopy (MT) is an essential diagnostic and therapeutic procedure for multiple pleural conditions such as pleurisy, pleural effusion, and pneumothorax. It is typically carried out when multiple thoracocentesis have failed to identify the cause of the pleural effusion. The diagnostic yield is maximized by medical thoracoscopy (MT)/pleuroscopy, which enables pleural biopsy under direct view utilizing several accessible (rigid or flexi-rigid) equipment. This research aims to study the role of medical thoracoscopy in the evaluation of pleural effusion.

This hospital-based prospective and interventional study will span from July 2022 to July 2024, enrolling 50 adult patients aged 18 years and older admitted to the Department of Respiratory Medicine, a tertiary care hospital in central India. Data will be collected using a structured proforma, encompassing demographic data, clinical history, and comorbidities. Diagnostic investigations, including pleural fluid analysis, sputum analysis, and radiological assessments, will be performed upon enrolment. The patients having undiagnosed pleural effusion will undergo a medical thoracoscopy after taking informed consent. The purpose of the study is to describe the diagnostic efficacy of thoracoscopy and to correlate its findings to pleural fluid parameters.