Diagnostic Efficacy of Uniportal Video-Assisted Thoracoscopic Surgery in Undiagnosed Pleural Effusion

Özet

Introduction: We aimed to evaluate the diagnostic efficacy of uniportal video-assisted thoracoscopic surgery (VATS) in undiagnosed pleural effusions. Methods: We examined the medical records of all consecutive patients with undiagnosed pleural effusions who underwent uniportal VATS between 2014 and 2018 at the Health Sciences University Antalya Practice and Research Center. We included 41 males (55.4%) and 33 females (44.5%) with a mean age of 64.12 y (range, 35–88 y) in the study. VATS was performed under general or local anesthesia according to the patients’ performance status. Pleural drainage and/or biopsies were performed through a single lumen with a 1–2 cm incision. A single chest tube was placed from the port entry after the procedure. The chest tube was left in place for a minimum of 3 days and removed when the fluid drainage was less than 100 ml/24 h. Patients were discharged the day after chest tube removal and a return visit was scheduled on postoperative day 30 for clinical evaluation and a new chest radiograph. Results: Pleural cytology was performed in all patients, whereas biopsies were performed in 53 patients (71.6%). Pathological examination of biopsies demonstrated that 56.6% of patients had a malignancy of the pleura and 43.4% had benign pleural diseases, and among them, 3.7% had tuberculosis. The overall diagnostic yield of VATS in the study was 60/74 (81.0%). The most common primary lung cancer with the involvement of the pleura was the adenocarcinoma (78.5%). The most common metastatic tumors originated from the lungs (46.6%), followed by the breasts (26.6%). There was no intraoperative mortality. Discussion and Conclusion: Uniportal VATS is well tolerated and safe for the diagnosis and treatment of undiagnosed pleural effusions.