الفهرس 
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Abstract
This study was conducted on 20 patients [aged from 35 to 70 years & 12
men and 8 women] with undiagnosed diffuse parenchymal lung disease who were
admitted to Chest Department, Faculty of Medicine, Menoufia University
Hospitals during the period from March 2017 to March 2019.
The patients underwent detailed history taking, clinical examination,
laboratory investigations including ABGs & coagulation profile, HRCT and
pulmonary function tests (PFT).
The aim of the work was to assess the role of medical thoracoscopy with
electro-cautery in the diagnosis of DPLD.
All the patients were subjected to thoracoscopic lung biopsy using medical
thoracoscopy and electro-cautery device to obtain samples for histiopathology and
seal any leak. The procedure was done under conscious sedation.
Assessment of the usefulness of this procedure was done by assessing the
ability of the biopsy samples to reach a conclusive diagnosis.
To asses safety of the procedure, direct complications related to the
procedure were assessed.
Regarding the usefulness in diagnosis, 95% of the cases were successfully
diagnosed. The most common diagnoses were hypersensitivity pneumonitis and
usual interstitial pneumonia, representing 25% for each. In the second place were
metastatic adenocarcinoma, NSIP and sarcoidosis, with 10% for each.
Adenocarcinoma in situ, organizing pneumonia and military tuberculosis were in
the third place with 5% for each. One case remained undiagnosed representing 5%
of cases.
Regarding the complications from the procedure, the percentage was 15%.
The complications were minor and successfully managed. One patient had
prolonged air leak which resolved with follow up. One patient had wound
infection managed by antibiotics. One patient had surgical emphysema which
resolved with high flow oxygen. No significant bleeding, residual pneumothorax,
respiratory failure, ICU admission or death had occurred.
There was significant correlation between complications and hospital stay.
There was insignificant correlation between final diagnosis and complications