Chellaraja, C (2013) The Value of Medical Thoracoscopy done at the Government Hospital of Thoracic Medicine, Tambaram sanatorium; In cases of Hemorrhgic Pleural Effusions. Masters thesis, Stanley Medical College, Chennai.
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Abstract
INTRODUCTION : The technique of medical thoracoscopy (or pleuroscopy) involves passing an endoscope through the thoracic cage and allows direct visualization and biopsies from the pleura. It is both a diagnostic and therapeutic procedure. Pleural fluid analysis, blind pleural biopsy, transthoracic needle aspiration are not always able to achieve a diagnosis in all cases. It is in this context that medical pleuroscopy or thoracoscopy is useful since the pleurae can be visualized and adequate sampling can be done. AIM OF THE STUDY : To study the value of thoracoscopic biopsy performed in cases of hemorrhagic pleural effusions, done at a tertiary care hospital in Tamilnadu , South India . MATERIALS AND METHODS : STUDY DESIGN: Descriptive, prospective, observational study STUDY POPULATION : All patients who satisfied the inclusion criteria were included in the study. The total number of patients was 82. [Male-57, female-25] STUDY PERIOD: May 2011 to April 2012. INCLUSION CRITERIA : 1. Patients with clinically and radiologically confirmed pleural effusion 2. Patients with hemorrhagic pleural effusion defined by three criteria- [a] pleural fluid RBC < 2,00,000 per mm3, [b] Pleural fluid hematocrit < 50% of peripheral blood, [c] Uniformly blood stained fluid in the tube while tapping of the effusion. EXCLUSION CRITERIA : 1. Patients with straw colored fluid during tapping, 2. Pleural fluid RBC> 2, 00,000 per mm3 of blood, 3. Pleural fluid hematocrit > 50 % - Hemothorax, 4. Patients with only initially blood stained fluid in the tube, 5. Patients not willing for the procedure, 6. Bleeding diathesis. RESULTS : The results of the value of thoracoscopic biopsy performed in 82 cases of hemorrhagic pleural effusions who satisfied the inclusion and exclusion criteria, done at a tertiary care hospital in Tamilnadu, South India. CONCLUSION : In cases that are classified as hemorrhagic effusions, early intervention in the form of medical thoracoscopy is valuable in both diagnostic and therapeutic aspects. The advantages include early relief of symptoms, early diagnosis and early initiation of appropriate therapy. The total hospital stay is comparatively less and the overall patient satisfaction is good. Malignancy and tuberculosis were the two leading causes of hemorrhagic effusions in this study. The complication rate was negligible.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Medical Thoracoscopy ; Government Hospital of Thoracic Medicine, Tambaram sanatorium ; In cases of Hemorrhgic Pleural Effusions. |
| Subjects: | MEDICAL > Tuberculosis and Respiratory Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 28 Feb 2018 18:03 |
| Last Modified: | 28 Feb 2018 18:03 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/5923 |
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