Pneumology - Original Articles Open access

Comparative study between ultrasound-guided closed pleural biopsy and thoracoscopic pleural biopsy in undiagnosed exudative pleural effusions

Authors

Published
18 March 2025
Section
Pneumology - Original Articles
DOI
10.4081/monaldi.2025.3361

Abstract

Pleural biopsies are often required to establish a diagnosis in exudative pleural effusions, which remain undiagnosed after initial pleural fluid analysis. Medical thoracoscopy offers a high diagnostic yield but has limited availability in resource-constrained settings. This prospective comparative study evaluated the diagnostic yield between ultrasound-guided closed pleural biopsy and medical thoracoscopy among patients with undiagnosed exudative pleural effusions with pleural-based lesions at least 10 mm in size. Both groups achieved an equal diagnostic yield of 92% despite fewer biopsy specimens being taken in the ultrasound-guided biopsy group (4.52±0.65) compared to the thoracoscopic group (7.8±1) (p<0.0001). In conclusion, ultrasound-guided closed pleural biopsy is a suitable alternative to medical thoracoscopy in patients with undiagnosed exudative pleural effusion having pleural thickening or nodularity of at least 10 mm in size, in terms of having a similar diagnostic yield as compared to medical thoracoscopy.

Keywords

Ethics Approval

This study received ethical clearance from the institute ethical committee (IEC/VMMC/SJH/Thesis/9/2022/CC-13), dated 6/10/2022.

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