Published online Apr 6, 2022. doi: 10.12998/wjcc.v10.i10.3088
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
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.
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.
This study investigated the diagnostic value of MT in patients with pleural effusion and evaluated its safety.
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.
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).
MT is an effective, safe, minimally invasive procedure with high diagnostic yield for pleural effusion of different causes.
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.