Korean J Thorac Cardiovasc Surg.  2014 Apr;47(2):124-128.

Is There a Role for a Needle Thoracoscopic Pleural Biopsy under Local Anesthesia for Pleural Effusions?

• Son HS
• Lee SH
• Darlong LM
• Jung JS
• Sun K
• Kim KT
• Kim HJ
• Lee K
• Lee SH
• Lee JT

Abstract

BACKGROUND
A closed pleural biopsy is commonly performed for diagnosing patients exhibiting pleural effusion if prior thoracentesis is not diagnostic. However, the diagnostic yield of such biopsies is unsatisfactory. Instead, a thoracoscopic pleural biopsy is more useful and less painful.
METHODS
We compared the diagnostic yield of needle thoracoscopic pleural biopsy performed under local anesthesia with that of closed pleural biopsy. Sixty-seven patients with pleural effusion were randomized into groups A and B. Group A patients were subjected to closed pleural biopsies, and group B patients were subjected to pleural biopsies performed using needle thoracoscopy under local anesthesia.
RESULTS
The diagnostic yields and complication rates of the two groups were compared. The diagnostic yield was 55.6% in group A and 93.5% in group B (p<0.05). Procedure-related complications developed in seven group A patients but not in any group B patients. Of the seven complications, five were pneumothorax and two were vasovagal syncope.
CONCLUSION
Needle thoracoscopic pleural biopsy under local anesthesia is a simple and safe procedure that has a high diagnostic yield. This procedure is recommended as a useful diagnostic modality if prior thoracentesis is non-diagnostic.

Keyword

Biopsy; Pleural disease; Pleural effusion; Tumor, malignant; Video-assisted thoracic surgery (VATS)

MeSH Terms

Anesthesia, Local*
Biopsy*
Humans
Needles*
Pleural Diseases
Pleural Effusion*
Pneumothorax
Syncope, Vasovagal
Thoracoscopy