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Abstract
Thoracoscopy has been present in the literature since the early 1900s . It has been widely practiced in its early days – for the surgical resection of adhesions for collapse therapy until the era of the antituberculous treatment started in the 1940s .
Thoracoscopy can be perfomed under local ansthesia and conscious sedation without the need for general ansethesia and double lumen intubation and can be applied to a multitude of indications encompassing most of the areas of the pulmonary speciality .
In this study, thirty patients with malignant pleural effusions were enrolled in the period between August 2001 . and September 2003 , in Armed forces hospitals .
Patients subjected to thoracocentesis , a closed pleural biopsy and thoracoscopic exploration of the pleural space .
Among the thirty patients enrolled , there were7 had mesothelioma and 22 had malignancy metastasizing to the pleura . Adenocarcinoma from various organs was the most encountered metastatic malignancy and squamous cell carcinoma was the commonest bronchogenic malignancy metastasizing to the pleura and one case undiagnosed .
The role of cytology in this study was very limited . It only yielded a definit diagnosis in one case of mesothelioma .
The Abrams needle was of limited help in diagnosing mesothelioma ( 2 out of 7 cases 6.7% ) .
The thoracoscopy was of great help in diagnosis in the rest of cases ( 4 cases of mesothelioma 100% and 22 cases of metastatic malignancy 96% ) .
We could do pleurodesis by abrading the parietal pleura in 10 cases and successful results were obtained ( 100% ) . In 19 cases we could do autologus blood pleurodesis , 15 cases were success ( 79% ) and 4 cases were failed ( 21% ) .
The complications that were seen in the thirty patients included a single case that has passed away two days post – procedur, two cases of surgical emphysema , two cases of hypoxemia , four cases of post procedure fever