Awake Versus Intubated Uniportal VATS Pleural Biopsy for the diagnosis Exudative Pleural Effusion: A prospective Single tertiary center study

Document Type : Original research articles

Authors

Department of Cardiothoracic surgery, Faculty of Medicine, Menoufia University, Shebin Elkoum, Menoufia, Egypt

10.21608/svuijm.2025.430008.2300

Abstract

Background: Using pleural fluid cytology and additional biochemical criteria, pleural effusion is typically diagnosed. The diagnostic utility of pleural fluid cytology is very high. Exudative effusions linked to TB or cancer are the most often misdiagnosed. For these reasons, targeted pleural biopsy using both awake and intubated uniportal video-assisted thoracoscopic surgery (VATS) is the basis for a definitive diagnosis.
Objectives: In order to diagnose exudative pleural effusion, this study compares the safety and effectiveness of awake video-assisted pleural biopsy (AVATS) with video-assisted thoracoscopic surgery (VATS).
Patients and methods: This prospective study was conducted at Menoufia University Hospital's Cardiothoracic Surgery department. Sixty patients who had an undetected exudative pleural effusion were included in the study. Group A: Awake Uniportal VATS (AVATS) and Group B: Uniportal Intubated VATS (Control Group) were the two randomly selected groups into which the patients were placed. Medical histories, clinical examinations, laboratory tests, and radiographic investigations were all performed on the patients. Age, gender, comorbidities, procedure safety, length of hospital stay, operation duration, and necessity for additional surgical procedures were also compared.
Results: Operation time differed significantly between groups (p<0.001), while hospital stay was shorter in the AVATS group but not statistically significant (p=0.06).Neither surgery was linked to any deaths, and there was no statistically significant difference in the rates of complications between the two groups (p=0.556).
Conclusion: For the evaluation of an undetected exudative pleural effusion, uniportal AVATS and VATS pleural biopsies are equally effective and safe.

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