Video-assisted thoracoscopic surgery for patients with undiagnosed exudative pleural effusion

Background: The most objective of assessment in patients with undiagnosed pleural effusion is to set up early diagnosis and encourage treatment with minimal invasive procedure. Video-assisted thoracoscopic surgery (VATS) is regularly considered as gold standard examination for an undiagnosed pleural effusion with great diagnostic value.
Objectives: This study was arranged to assess the role of (VATS) in the diagnosis of unexplained exudative pleural effusion.
Patients and Methods: This is a retrospective study included all patients who underwent VATS for undiagnosed exudative pleural effusion patients from 2014 to 2020.
Results: Total 105 patients who underwent VATS for undiagnosed pleural effusion in this time period as the diagnostic as well as therapeutic methods were included in the study. The overall mean age was 46.5± 20.71 and we had 51 Males (48.57%) and 54 Females (51.43%).There were 48 patients (54.29%) with co-morbidities most of them had diabetes mellitus (DM) in 36 patients (34.29%). The most common radiological findings were right free pleural effusion in 45 patients (42.86%) and pleural thickness in 42 patients (40%).VATS pleural drainage and biopsy (right and left) most common performed procedure in 75 patients (71.43%).Final histopathological diagnosis was nonspecific inflammation in 15 patients (14.29%), pleural TB in 57 patients(54.29%) and malignancy in 33patients (31.43%).
Conclusion: VATS is a good diagnostic and therapeutic method. Therefore, patients had undiagnosed exudative pleural effusions should be underwent VATS after failure of diagnosis by the initial workup as soon as possible to reach clear diagnosis.