Diagnostic yield and safety of closed needle pleural biopsy in exudative pleural effusion
Background: Closed pleural biopsy was previously considered a procedure of choice in cases of undiagnosed pleural effusion with good efficacy. Currently, the closed pleural biopsy has been replaced by thoracoscopic biopsy but not easily available in resource-limited setups. Objective: The objective...
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| Format: | Article |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2017-07-01
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| Series: | Avicenna Journal of Medicine |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.4103/ajm.AJM_112_16 |
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| author | Govind Singh Rajawat Supreet Batra Rajendra Prasad Takhar Lalit Rathi Chand Bhandari Manohar Lal Gupta |
| author_facet | Govind Singh Rajawat Supreet Batra Rajendra Prasad Takhar Lalit Rathi Chand Bhandari Manohar Lal Gupta |
| author_sort | Govind Singh Rajawat |
| collection | DOAJ |
| description | Background: Closed pleural biopsy was previously considered a procedure of choice in cases of undiagnosed pleural effusion with good efficacy. Currently, the closed pleural biopsy has been replaced by thoracoscopic biopsy but not easily available in resource-limited setups. Objective: The objective of this study was to analyze the diagnostic yield and safety of closed needle pleural biopsy in exudative pleural effusion and assessment of patients' characteristics with the yield of pleural biopsy. Design: This was a cross-sectional study. Settings: This study was conducted at Institute of Respiratory Diseases, SMS Medical College, Jaipur, a tertiary care center of West India. Patients and Methods: A total of 250 cases of pleural effusion were evaluated with complete pleural fluid biochemical, microbiological, and cytological examination. Out of these 250 patients, 59 were excluded from the study as the diagnosis could be established on initial pleural fluid examination. The remaining (191) patients were considered for closed pleural biopsy with Abrams pleural biopsy needle. Main Outcome Measures: The main outcome measure was diagnostic yield in the form of confirming diagnosis. Results: Out of the 191 patients with exudative lymphocytic pleural effusion, 123 (64.40%) were diagnosed on the first pleural biopsy. Among the remaining 68 patients, 22 patients had repeat pleural biopsy with a diagnostic yield of 59.9%. The overall pleural biopsy could establish the diagnosis in 136 (71.20%) patients with pleural effusion. The most common diagnosis on pleural biopsy was malignancy followed by tuberculosis. Conclusions: Closed pleural biopsy provides diagnostic yield nearly comparative to thoracoscopy in properly selected patients of pleural effusions. In view of good yield, low cost, easy availability, and very low complication rate, it should be used routinely in all cases of undiagnosed exudative lymphocytic pleural effusion. Limitations: There was no comparison with a similar group undergoing thoracoscopic pleural biopsy. |
| first_indexed | 2024-12-22T07:56:25Z |
| format | Article |
| id | doaj.art-2afba55713dc4aa4aafd206b462bdb47 |
| institution | Directory Open Access Journal |
| issn | 2231-0770 2249-4464 |
| language | English |
| last_indexed | 2024-12-22T07:56:25Z |
| publishDate | 2017-07-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Avicenna Journal of Medicine |
| spelling | doaj.art-2afba55713dc4aa4aafd206b462bdb472022-12-21T18:33:21ZengThieme Medical and Scientific Publishers Pvt. Ltd.Avicenna Journal of Medicine2231-07702249-44642017-07-01070312112410.4103/ajm.AJM_112_16Diagnostic yield and safety of closed needle pleural biopsy in exudative pleural effusionGovind Singh Rajawat0Supreet Batra1Rajendra Prasad Takhar2Lalit Rathi3Chand Bhandari4Manohar Lal Gupta5Department of Chest and Tuberculosis, SMS Medical College, Jaipur, Rajasthan, IndiaDepartment of Respiratory Medicine, VP Chest Institute, University of Delhi, New Delhi, IndiaDepartment of Respiratory Medicine, Government Medical College, Kota, Rajasthan, IndiaDepartment of Chest and Tuberculosis, SMS Medical College, Jaipur, Rajasthan, IndiaDepartment of Chest and Tuberculosis, SMS Medical College, Jaipur, Rajasthan, IndiaDepartment of Chest and Tuberculosis, SMS Medical College, Jaipur, Rajasthan, IndiaBackground: Closed pleural biopsy was previously considered a procedure of choice in cases of undiagnosed pleural effusion with good efficacy. Currently, the closed pleural biopsy has been replaced by thoracoscopic biopsy but not easily available in resource-limited setups. Objective: The objective of this study was to analyze the diagnostic yield and safety of closed needle pleural biopsy in exudative pleural effusion and assessment of patients' characteristics with the yield of pleural biopsy. Design: This was a cross-sectional study. Settings: This study was conducted at Institute of Respiratory Diseases, SMS Medical College, Jaipur, a tertiary care center of West India. Patients and Methods: A total of 250 cases of pleural effusion were evaluated with complete pleural fluid biochemical, microbiological, and cytological examination. Out of these 250 patients, 59 were excluded from the study as the diagnosis could be established on initial pleural fluid examination. The remaining (191) patients were considered for closed pleural biopsy with Abrams pleural biopsy needle. Main Outcome Measures: The main outcome measure was diagnostic yield in the form of confirming diagnosis. Results: Out of the 191 patients with exudative lymphocytic pleural effusion, 123 (64.40%) were diagnosed on the first pleural biopsy. Among the remaining 68 patients, 22 patients had repeat pleural biopsy with a diagnostic yield of 59.9%. The overall pleural biopsy could establish the diagnosis in 136 (71.20%) patients with pleural effusion. The most common diagnosis on pleural biopsy was malignancy followed by tuberculosis. Conclusions: Closed pleural biopsy provides diagnostic yield nearly comparative to thoracoscopy in properly selected patients of pleural effusions. In view of good yield, low cost, easy availability, and very low complication rate, it should be used routinely in all cases of undiagnosed exudative lymphocytic pleural effusion. Limitations: There was no comparison with a similar group undergoing thoracoscopic pleural biopsy.http://www.thieme-connect.de/DOI/DOI?10.4103/ajm.AJM_112_16closed pleural biopsymalignant pleural effusionthoracoscopic pleural biopsytubercular pleural effusion |
| spellingShingle | Govind Singh Rajawat Supreet Batra Rajendra Prasad Takhar Lalit Rathi Chand Bhandari Manohar Lal Gupta Diagnostic yield and safety of closed needle pleural biopsy in exudative pleural effusion Avicenna Journal of Medicine closed pleural biopsy malignant pleural effusion thoracoscopic pleural biopsy tubercular pleural effusion |
| title | Diagnostic yield and safety of closed needle pleural biopsy in exudative pleural effusion |
| title_full | Diagnostic yield and safety of closed needle pleural biopsy in exudative pleural effusion |
| title_fullStr | Diagnostic yield and safety of closed needle pleural biopsy in exudative pleural effusion |
| title_full_unstemmed | Diagnostic yield and safety of closed needle pleural biopsy in exudative pleural effusion |
| title_short | Diagnostic yield and safety of closed needle pleural biopsy in exudative pleural effusion |
| title_sort | diagnostic yield and safety of closed needle pleural biopsy in exudative pleural effusion |
| topic | closed pleural biopsy malignant pleural effusion thoracoscopic pleural biopsy tubercular pleural effusion |
| url | http://www.thieme-connect.de/DOI/DOI?10.4103/ajm.AJM_112_16 |
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