Title: CT-scan guided Abrams needle pleural biopsy or medical thoracoscopy: which method in which patient
Abstract:<b>Background:</b> No consensus exists regarding which biopsy methods are appropriate for specific procedures in pleural diseases. In this ongoing randomized-prospective study, we aim to compare compu...<b>Background:</b> No consensus exists regarding which biopsy methods are appropriate for specific procedures in pleural diseases. In this ongoing randomized-prospective study, we aim to compare computed tomography scan guided pleural biopsy using an Abrams' needle (CT-ANPB) with medical thoracoscopy (MT) according to the CT findings of the patients with respect to both diagnostic yield and safety. <b>Methods:</b> A total of 71 patients with exudative pleural effusion who could not be diagnosed by cytological analysis were included. All patients were separated to two groups regarding to the CT findings: Only pleural effusion or pleural effusion with pleural thickening/lesion. In each group, the patients were randomized into either underwent CT-ANPB or either underwent MT. The two groups were compared in terms of diagnostic sensitivity, accuracy and the complications. <b>Results:</b> In only pleural effusion group, 33 patients, CT-ANPB had a diagnostic sensitivity of 63.6%, as compared to 80.0% for MT. Accuracy for both methods are 73.3%, and 90.5%, respectively. Pleural effusion with pleural thickening/lesion group, 38 patients, CT-ANPB had a diagnostic sensitivity of 85.7%, as compared to 100% for MT. Accuracy for both methods are 87.5%, and 100%, respectively. CT-ANPB's sensitivity was low in only pleural effusion group with respect to others (p=0.044). There was no difference between CT-ANPB and MT in patients who had pleural fluid and pleural thickening/lesion in CT scans. Complication rates were low and acceptable. <b>Conclusion:</b> For patients with only pleural fluid appearance on CT the primary method of diagnosis should be medical thoracoscopy. We will get clearer opinion as the number of patients increases.Read More
Publication Year: 2019
Publication Date: 2019-09-28
Language: en
Type: article
Indexed In: ['crossref']
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