Pleuroscopy as a Diagnostic Method in Patients with Previous Closed Pleural Biopsy without Conclusive Results
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Abstract
Introduction: Pleuroscopy is a minimally invasive technique that explores the pleural cavity and allows taking targeted biopsies of the parietal pleura. It is a highly cost-effective diagnostic method for unexplained exudative pleural effusion (PE). There is little evidence on its use in our region.
Material and Methods: This is a retrospective, descriptive study conducted between June 1, 2024, and January 31, 2025. Adult patients hospitalized for pleural effusion with negative cytochemical and cytological studies, and non diagnostic closed pleural biopsy with an Abrams needle were included. Analysis included patients’ demographic data, type of tube used, time until tube removal, and post-procedure discharge, histopathological results, and complications.
Results: Fifteen pleuroscopies were performed. A specific histopathological diagnosis was established in 86% (13/15) of the patients in the study, 77.7% (7/9) of the patients with forceps biopsy, and 100% (6/6) of the patients with cryoprobe biopsy. The histopathological diagnoses were malignant neoplasia (8/15), inflammatory/infectious (5/15), and undiagnosed (2/15). One patient with chest wall seroma and one patient with post-procedural respiratory failure were recorded as complications.
Conclusions: Pleuroscopy allows taking parietal pleural biopsies under direct vision through a trocar, using forceps and cryoprobes. In this study, we demonstrated that it is a cost-effective and safe diagnostic alternative in patients whose previous fluid analysis and closed pleural biopsy were inconclusive.
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