Document Type : Original Article
Authors
1
Assistant Professor of Cardiothoracic Surgery Department, Faculty of Medicine, Zagazig university, Egypt
2
Professor of Cardiothoracic Surgery Department, Faculty of Medicine, Zagazig university, Egypt
3
Department of Cardiothoracic Surgery, Faculty of Medicine, Tripoli University, Labia
4
Lecturer of Cardiothoracic Surgery Department, Faculty of Medicine, Zagazig university, Egypt
Abstract
Background: Pleural effusion is a condition where fluid collects between the layers of the pleura around the lungs. Treatment usually starts with removing some of the fluid using a needle (thoracentesis) to relieve symptoms and find out the cause. Video-Assisted Thoracoscopic Surgery (VATS) is a modern, minimally invasive procedure that helps doctors see inside the chest with a small camera. This study aimed to evaluate the role of VATS in the diagnosis and management of undiagnosed pleural effusion. Methods: This prospective study was conducted on 48 patients with pleural effusion. All patients underwent a comprehensive evaluation, sputum smears examinations, thoracocentesis and the aspirated pleural fluid sent for a chemical, bacteriological and cytological examination. All the undiagnosed cases after complete evaluation were considered and given the option for diagnostic and therapeutic VATS. Results: This study, bacteriological and cytological analyses of pleural fluid provided valuable insights into the underlying etiologies of pleural effusion. Gram staining was positive in 18.75% of patients, identifying Staphylococcus aureus in 10.4%, Streptococcus pneumoniae in 6.25%, and Escherichia coli in 2.1%. Culture positivity was noted in 14.6% of cases, including Streptococcus pneumoniae (6.25%), Staphylococcus aureus (4.2%), E. coli (2.1%), and Mycobacterium tuberculosis (2.1%). Acid-fast bacilli (AFB) smears confirmed tuberculosis in 6.25% of patients. Cytological examination identified malignant cells in 33.3% of cases, while tissue biopsy confirmed malignancy in 43.75%. Conclusion: that VATS is a safe and diagnostic tool in the evaluation and management of pleural effusion, particularly in cases where initial investigations fail to determine the underlying etiology.
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