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 Currently, the closed pleural biopsy has been replaced by thoracoscopic biopsy but not easily available in resource-limited setups.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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Autores principales:	Govind Singh Rajawat, Supreet Batra, Rajendra Prasad Takhar, Lalit Rathi, Chand Bhandari, Manohar Lal Gupta
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Medical and Scientific Publishers Pvt. Ltd. 2017
Materias:	closed pleural biopsy malignant pleural effusion thoracoscopic pleural biopsy tubercular pleural effusion Medicine R
Acceso en línea:	https://doaj.org/article/2afba55713dc4aa4aafd206b462bdb47
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spelling	oai:doaj.org-article:2afba55713dc4aa4aafd206b462bdb472021-12-02T16:37:41ZDiagnostic yield and safety of closed needle pleural biopsy in exudative pleural effusion2231-07702249-446410.4103/ajm.AJM_112_16https://doaj.org/article/2afba55713dc4aa4aafd206b462bdb472017-07-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.4103/ajm.AJM_112_16https://doaj.org/toc/2231-0770https://doaj.org/toc/2249-4464Background: 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 Currently, the closed pleural biopsy has been replaced by thoracoscopic biopsy but not easily available in resource-limited setups.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.Govind Singh RajawatSupreet BatraRajendra Prasad TakharLalit RathiChand BhandariManohar Lal GuptaThieme Medical and Scientific Publishers Pvt. Ltd.articleclosed pleural biopsymalignant pleural effusionthoracoscopic pleural biopsytubercular pleural effusionMedicineRENAvicenna Journal of Medicine, Vol 07, Iss 03, Pp 121-124 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	closed pleural biopsy malignant pleural effusion thoracoscopic pleural biopsy tubercular pleural effusion Medicine R
spellingShingle	closed pleural biopsy malignant pleural effusion thoracoscopic pleural biopsy tubercular pleural effusion Medicine R 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
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.
format	article
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
title	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_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_sort	diagnostic yield and safety of closed needle pleural biopsy in exudative pleural effusion
publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
publishDate	2017
url	https://doaj.org/article/2afba55713dc4aa4aafd206b462bdb47
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_version_	1718383621167906816

Diagnostic yield and safety of closed needle pleural biopsy in exudative pleural effusion

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