Comparative study of diagnostic yield of thoracoscopic pleural biopsy v/s repeat closed pleural biopsy in patient having negative first closed pleural biopsy

Introduction: Pleural effusion is one of the most commonly encountered clinical conditions in pulmonary practice. In India common causes of pleural effusion are tuberculosis, Para pneumonic effusion, malignancy, congestive heart failure, renal failure, connective tissue disorders and pulmonary embolism. As many as 15–20% of all pleural effusions remain undiagnosed at various level despite intensive effort. To solve the dilemma of these undiagnosed cases of pleural effusion, we have two options in the form of closed pleural biopsy (CPB) and thoracoscopic pleural biopsy (TPB). So this study is planned to compare the diagnostic yield, safety of either technique. Material and methods: This was a hospital based prospective interventional study. It was carried out from JAN 2018 to DEC 2018 at tertiary care hospital & medical college (Department of Respiratory Medicine of Sardar Patel Medical college) Bikaner, Rajasthan. We have taken 100 cases ( age 18 to 70 years) reported to Department of Respiratory Medicine for undiagnosed exudative pleural effusion. Initial closed pleural biopsy was done on these patients. Patients with negative initial closed pleural biopsy was randomized into two groups, Group A and Group B. Group A has been subjected to closed pleural biopsy with Abrams needle and four to six biopsy specimens has been taken. Group B was subjected to Medical Thoracoscopic pleural biopsy. Diagnostic yield of both procedures was calculated and comparison has been done with the help of appropriate statistical tools and conclusion has been drawn. Results: In our study, diagnostic yield of medical thoracoscopy