THORACOSCOPIC MANAGEMENT OF MALIGNANT PLEURAL EFFUSION

The results of thoracoscopic biopsy and talc pleurodesis in the manage ment of malignant pleural effusions, is analysed. The study population consisted of 213 patients. Pre-operative cytology was positive in onl y 27% of patients; the diagnostic yield using thoracoscopic biopsy was 91.5%. (Sensitivity 99%; specificity 100%; positive predicted value 1 00%; negative predicted value 88%). Talc pleurodesis at thoracoscopy p roduced symptomatic improvement in 93% of patients. Post-operative com plications occurred in 3.7% and there was a 2.3% mortality. Recurrent effusion was not a significant clinical problem. Thoracoscopy enhances the accuracy of diagnosis of pleural effusions; simultaneous talc ple urodesis has a high therapeutic success.