THORACOSCOPY IN THE DIAGNOSIS AND MANAGEMENT OF CHRONIC PLEURAL EFFUSIONS

Thoracoscopy was performed in 76 patients with chronic pleural effusio ns in which thoracocentesis and blind needle biopsy failed to reach a precise diagnosis. Analysis of thoracoscopic biopsies provided a defin itive diagnosis in 53 of the 76 subjects. The diagnoses included 35 ma lignant diseases in which the macroscopic appearance was diagnostic in only 27 patients. Among these 76 patients, a talc poudrage was perfor med in the management of recurrent effusion in 33 patients. No recurre nce of pleural effusion was observed after 1 month in 87% and after 6 months in 76% of patients with recurrent pleural effusion. We confirm that thoracoscopy is a safe and useful technique for the diagnosis of pleural effusion which substantially decreases the necessity for diagn ostic thoracotomy and that talc poudrage is effective to achieve pleur odesis.