Comparative study between V.A.T.S and thoracostmy tube in revealing pathologic causes of pleural effusion

ABSTRACT

V.A.T.S. [Vidio-Assisted Theorocoscopic Surgery] is now an acceptable alternative to thoracotomy in different clinical situations, such as L.N. biopsy, lung biopsy, solitary pulmonary nodules [S.P.N.] ... etc. In this study, we managed 100 cases of pleural effusion [P.E.] to identify the causative pathology. Filly cases were managed by intercostal tube drainage plus bacteriologic and histologic sampling of the drainage [Group A], another 50 cases were subjected to V.A.T.S. aiming at diagnosing the cause of P.E. [Group B]. 11 cases [22%]-from group "A" failed to be diagnosed by routine bacteriologic and histopathologic examination of the drainage fluid. They were subjected to Thoracotomy, where direct biopsy from suspected areas revealed the diagnosis. All cases from group B were diagnosed. We conclude that in sub-acute and chronic P.E., V.A.T.S. is presumably preferable as a first line of treatment