Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 6, 2022; 10(10): 3088-3100
Published online Apr 6, 2022. doi: 10.12998/wjcc.v10.i10.3088
Diagnostic value and safety of medical thoracoscopy for pleural effusion of different causes
Xiao-Ting Liu, Xi-Lin Dong, Yu Zhang, Ping Fang, Hong-Yang Shi, Zong-Juan Ming
Xiao-Ting Liu, Yu Zhang, Ping Fang, Hong-Yang Shi, Zong-Juan Ming, Department of Respiratory Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
Xi-Lin Dong, Department of Respiratory, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
Author contributions: Dong XL conceived and designed the study; Liu XT and Zhang Y analyzed the data and collected the related clinical information; Liu XT drafted the manuscript; Fang P, Shi HY and Ming ZJ revised the manuscript critically for important intellectual content; All authors have read and approved the final manuscript.
Supported by Shaanxi Science and Technology Research Plan Program, Shaanxi, China, No. 2020SF-106.
Institutional review board statement: This study was approved by the Ethics Committee of The Second Affiliated Hospital of Xi'an Jiaotong University (No. 2021055).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xi-Lin Dong, PhD, Chief Doctor, Department of Respiratory, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 Xiwu Road, Xi'an 710004, Shaanxi Province, China. dxl1103@163.com
Received: September 13, 2021
Peer-review started: September 13, 2021
First decision: January 18, 2022
Revised: January 31, 2022
Accepted: February 23, 2022
Article in press: February 23, 2022
Published online: April 6, 2022
Processing time: 196 Days and 21.2 Hours
ARTICLE HIGHLIGHTS
Research background

In clinical practice, most patients with pleural effusion can be diagnosed definitively according to clinical history, symptoms, signs, and relevant examinations, but some undiagnosed and misdiagnosed patients still remain and miss the best time for treatment. However, minimally invasive techniques such as medical thoracoscopy (MT) have significantly improved the diagnostic yield and cure rate, especially in patients with undiagnosed pleural effusion. Therefore, evaluating the effectiveness and safety of MT has been key in the extensive development of this technology.

Research motivation

This study retrospectively analyzed the diagnostic efficacy and safety of MT in patients with pleural effusion, to comprehensively evaluate the practicability of MT and provide evidence support for large-scale clinical application.

Research objectives

This study investigated the diagnostic value of MT in patients with pleural effusion and evaluated its safety.

Research methods

We obtained the clinical data of patients from the electronic medical system of our hospital, and summarized the baseline characteristics, MT results, and adverse reactions of 106 patients with pleural effusions. In addition, SPSS 18.0 software was used to analyze the single and multiple factors of patients with pleural effusions and establish the receiver operating characteristic curve (ROC) model to predict the value of these factors in differential diagnosis.

Research results

MT improved the diagnostic yield of pleural effusion (69.8%), especially malignant pleural effusion (75.9%) but not tuberculous pleural effusion (38.7%). We found that the incidence of adverse reactions was low, and chest pain at the entry site was largely seen. Logistic regression analysis identified bloody pleural effusion, and carcinoembryonic antigen had good predictive value in differentiating between malignant and tuberculous pleural effusion with an area under the ROC of 0.977 (P < 0.001).

Research conclusions

MT is an effective, safe, minimally invasive procedure with high diagnostic yield for pleural effusion of different causes.

Research perspectives

In recent years, increasingly improved diagnostic yield and cure rate of pleural effusions have been due to MT. However, some restrictions from promotion and technology itself contribute to undiagnosis and misdiagnosis. In the future, we should be committed to continuously innovating this technology to improve its clinical benefits.