Diagnostic value and safety of medical thoracoscopy for pleural effusion of different causes

Liu, Xiaoting; Dong, Xia; Fang, Ping; Shi, Hongyang; Zhou, Ming

doi:10.12998/wjcc.v10.i10.3088

Cited by 10 publications

(13 citation statements)

References 33 publications

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“…Application of the VATS approach allows for complete draining of the fluid. Because it provides a better rate of pleural surface reaction, there are publications stating that the VATS approach provides more effective treatment overall [19][20][21]. At the same time, it yields more diagnostic information for clinicians.…”

Section: Discussionmentioning

confidence: 99%

Managing malignant pleural effusions: A single center’s experience

Gökçe¹,

Akboga²

2022

Med-Science

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Occurring among the most common findings in cases of metastatic disease, malignant pleural effusion (MPE) is identified in up to 15% of patients with cancer. This research was undertaken to provide an overview of advances in the treatment of MPE in recent years. A total of 186 patients with MPE were evaluated retrospectively after having consulted or been hospitalized in our hospital between March 2019 and December 2021. The evaluated data included gender, age, cause of effusion, treatment method, length of hospital stay, and complications. Lung cancer was in first place, affecting 64 of the patients treated for MPE. In this cohort, 142 patients had received a cytological diagnosis. These patients underwent pleurodesis with talc after tube thoracostomy. A definitive diagnosis could not be determined from the cytological samples of 44 patients. VATS was performed diagnostically and then pleurodesis was performed with postoperative talc. The complication rate was 13%. The mortality rate was 5%. Recurrence was observed in 37 patients during the 2-month follow-up period after the procedure. The optimal treatment of MPE remains uncertain, and treatment decisions require the cooperation of many medical departments. Nowadays, less invasive approaches are preferred in managing cases of pleural effusion. This treatment approach protects patients from the risks of more invasive interventions and reduces treatment costs.

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Section: Discussionmentioning

confidence: 99%

Managing malignant pleural effusions: A single center’s experience

Gökçe¹,

Akboga²

2022

Med-Science

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“…Clinical history and physical examination provide essential insights into a patient's health. Still, their limitations underscore the need for supplementary diagnostic tools, particularly in scenarios where a definitive diagnosis remains elusive [ 11 ].…”

Section: Reviewmentioning

confidence: 99%

“…These techniques offer valuable information regarding the presence and potential causes of effusions. However, they may only sometimes suffice for a definitive diagnosis, emphasizing the importance of combining imaging findings with other diagnostic methods for a more comprehensive understanding of the underlying pathology [ 11 ].…”

Section: Reviewmentioning

confidence: 99%

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Unveiling Insights: A Comprehensive Review of the Role of Medical Thoracoscopy in Pleural Effusion Assessment

Ledwani,

Ghewade,

Jadhav

et al. 2024

Cureus

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Pleural effusion, characterized by abnormal fluid accumulation in the pleural cavity, poses diagnostic and therapeutic challenges across various medical conditions. This comprehensive review explores the role of medical thoracoscopy in assessing pleural effusions, providing insights into its historical context, procedural intricacies, diagnostic performance, safety considerations, and clinical applications. Medical thoracoscopy, a minimally invasive endoscopic procedure, offers advantages such as high diagnostic yield, therapeutic interventions, real-time assessment, and a minimally invasive nature. The review critically analyzes the procedure's advantages and disadvantages, including technical expertise, risk of complications, resource intensity, and patient selection criteria. Comparative analyses with alternative diagnostic modalities highlight the unique benefits of medical thoracoscopy in specific clinical scenarios. The diagnostic yield of medical thoracoscopy is examined, considering sensitivity and specificity in various contexts. Patient selection criteria, complications, and safety measures are discussed, emphasizing the importance of careful consideration in integrating thoracoscopy into clinical practice. The review further explores its clinical applications, including differentiating exudative and transudative effusions, identifying specific etiologies, and its role in treatment planning. In conclusion, medical thoracoscopy emerges as a valuable tool in the comprehensive management of pleural effusions, offering a nuanced approach to diagnosis and treatment. The evolving landscape of diagnostic modalities underscores the continued significance of medical thoracoscopy and potential advancements in the field.

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“…A high specificity is also necessary for tests concerning the differential diagnosis of pleural lesions, the greatest of which is obtained with pleural biopsies. The complication rate, morbidity, and costs associated with pleural biopsies depend on the procedure utilized to attain the specimen, such as medical thoracoscopy, thoracic surgery, and transthoracic imaging-guided biopsy [19].…”

Section: Introductionmentioning

confidence: 99%

Pleural Mesothelioma: Advances in Blood and Pleural Biomarkers

Sorino,

Mondoni,

Marchetti

et al. 2023

JCM

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Pleural mesothelioma (PM) is a type of cancer that is highly related to exposure to asbestos fibers. It shows aggressive behavior, and the current therapeutic approaches are usually insufficient to change the poor prognosis. Moreover, apart from staging and histological classification, there are no validated predictors of its response to treatment or its long-term outcomes. Numerous studies have investigated minimally invasive biomarkers in pleural fluid or blood to aid in earlier diagnosis and prognostic assessment of PM. The most studied marker in pleural effusion is mesothelin, which exhibits good specificity but low sensitivity, especially for non-epithelioid PM. Other biomarkers found in pleural fluid include fibulin-3, hyaluronan, microRNAs, and CYFRA-21.1, which have lower diagnostic capabilities but provide prognostic information and have potential roles as therapeutic targets. Serum is the most investigated matrix for biomarkers of PM. Several serum biomarkers in PM have been studied, with mesothelin, osteopontin, and fibulin-3 being the most often tested. A soluble mesothelin-related peptide (SMRP) is the only FDA-approved biomarker in patients with suspected mesothelioma. With different serum and pleural fluid cut-offs, it provides useful information on the diagnosis, prognosis, follow-up, and response to therapy in epithelioid PM. Panels combining different markers and proteomics technologies show promise in terms of improving clinical performance in the diagnosis and monitoring of mesothelioma patients. However, there is still no evidence that early detection can improve the treatment outcomes of PM patients.

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Diagnostic value and safety of medical thoracoscopy for pleural effusion of different causes

Cited by 10 publications

References 33 publications

Managing malignant pleural effusions: A single center’s experience

Managing malignant pleural effusions: A single center’s experience

Unveiling Insights: A Comprehensive Review of the Role of Medical Thoracoscopy in Pleural Effusion Assessment

Pleural Mesothelioma: Advances in Blood and Pleural Biomarkers

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