Role of Video Assisted Thoracoscopic Surgery for Management of Pleural Effusion | ||||
| Zagazig University Medical Journal | ||||
| Volume 31, Issue 8, August 2025, Page 4107-4119 PDF (1.02 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/zumj.2025.389023.3971 | ||||
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| Authors | ||||
Amr Hassan Mansour Hassan1; Mahmoud Mohamed Abdrabo2; Abdulwahhab Mustafa Salim Hablous  3; Ehab Sabry Elalfy4
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| 1Assistant Professor of Cardiothoracic Surgery Department, Faculty of Medicine, Zagazig university, Egypt | ||||
| 2Professor of Cardiothoracic Surgery Department, Faculty of Medicine, Zagazig university, Egypt | ||||
| 3Department of Cardiothoracic Surgery, Faculty of Medicine, Tripoli University, Labia | ||||
| 4Lecturer of Cardiothoracic Surgery Department, Faculty of Medicine, Zagazig university, Egypt | ||||
| Abstract | ||||
| Background: Pleural effusion is a condition where fluid collects between the layers of the pleura around the lungs. Treatment usually starts with removing some of the fluid using a needle (thoracentesis) to relieve symptoms and find out the cause. Video-Assisted Thoracoscopic Surgery (VATS) is a modern, minimally invasive procedure that helps doctors see inside the chest with a small camera. This study aimed to evaluate the role of VATS in the diagnosis and management of undiagnosed pleural effusion. Methods: This prospective study was conducted on 48 patients with pleural effusion. All patients underwent a comprehensive evaluation, sputum smears examinations, thoracocentesis and the aspirated pleural fluid sent for a chemical, bacteriological and cytological examination. All the undiagnosed cases after complete evaluation were considered and given the option for diagnostic and therapeutic VATS. Results: This study, bacteriological and cytological analyses of pleural fluid provided valuable insights into the underlying etiologies of pleural effusion. Gram staining was positive in 18.75% of patients, identifying Staphylococcus aureus in 10.4%, Streptococcus pneumoniae in 6.25%, and Escherichia coli in 2.1%. Culture positivity was noted in 14.6% of cases, including Streptococcus pneumoniae (6.25%), Staphylococcus aureus (4.2%), E. coli (2.1%), and Mycobacterium tuberculosis (2.1%). Acid-fast bacilli (AFB) smears confirmed tuberculosis in 6.25% of patients. Cytological examination identified malignant cells in 33.3% of cases, while tissue biopsy confirmed malignancy in 43.75%. Conclusion: that VATS is a safe and diagnostic tool in the evaluation and management of pleural effusion, particularly in cases where initial investigations fail to determine the underlying etiology. | ||||
| Keywords | ||||
| Pleural effusion; Video-Assisted Thoracoscopic Surgery; Thoracentesis | ||||
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