Video-Assissed Thoracoscopic Biopsy and Treatment for Unknown Pleural Effusion

Objective: To evaluate the video-assisted thoracoscopic surgery(VATS) in the diagnosis and treatment of unknown pleural effusion.Methods: From April 2005 to April 2011,video-assisted thoracoscopic surgeries of thoracoscopic exploration,adhe-siotomy,thoracoscopic biopsy and thoracoscopic pleurodesis in patients with malignant pleural effusion were carried out in 196 patients with unknown pleural effusion.Results: Via VATS,all the 196 patients were diagnosed accurately: malignant pleural effusion in 140,tu-berculotic pleural effusion in 36,inflammatory pleural effusion in 20.The procedure involved VATS procedure was 178,VATS combined mini-incision thoracotomy was 18.The duration of VATS procedure ranged from 30 to75 minutes with a mean of 54 minutes.The amount of bleeding from 10 to120 mL with a mean of 53 mL.10 cases developed air leak The chest tube was removed when the amount of fluid was less 50 mL/24 h,The duration of chest drainage ranged from 4 to19 days with a mean of 9.4 days.The pleural effu-sion was success-fully controlled in 191 patients.There was no death during the hospital stay.22 patients with malignant pleural effusion toke chemothera-py were followed up for 14 to 34 months(mean,23 months).Chest X-ray performed during the period showed no pleural effusion,pneu-mothorax or other pleural effusion-related complications.Conclusion: VATS is effective for the diagnosis and treatment of unknown pleural effusion with less surgical injuries and good outcomes in selected patients.