Outcome of Patients Undiagnosed Under Medical Thoracoscopy

Study Overview
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Brief Summary
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Medical thoracoscopy (MT) under local anaesthetic and mild sedation, an established method in the diagnosis of pleural diseases. MT has an overall diagnostic yield above 90% for malignant pleural diseases and pleural tuberculosis. However, others who are diagnosed as fibrinous pleuritis make confusion in clinicians. Whether these patients are firmly followed or not ? The investigators do not know the answer of this question. In this study the investigators aimed to investigate the outcome of the patients who are diagnosed as fibrinous pleuritis on MT biopsies.

Detailed Description
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Medical thoracoscopy (MT) under local anaesthetic and mild sedation, an established method in the diagnosis of pleural diseases with a sensitivity above 90% and specificity of 1000% for malignant pleural diseases and pleural tuberculosis. Except these two groups of patients, in others pleural histopathological diagnosis is defined as non-specific pleuritis or fibrinous pleuritis. Authors say that the natural evolution of these patients is poorly understood. Some of these patients was later established false negative cases for malignant pleural diseases. Clinical guidelines recommend close observation of patients with undiagnosed exudative effusions, although the length and follow-up regime is not defined, yet. In this study the investigators examine the outcome of patients who are diagnosed as fibrinous pleuritis by MT.

Official Title
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Outcome of Patients Who Could Not Have Been Diagnosed by Medical Thoracoscopy

Conditions
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Pleural Diseases

Intervention / Treatment
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* Procedure: Medical thoracoscopy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Undiagnosed exudative pleural effusion Under 20 years-old, over 85 years-old Followed 2 years at least Exclusion Criteria: Transudative pleural effusion Patients who do not accepted medical thoracoscopy.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients underwent medical thoracoscopy<br>Patients who require medical thoracoscopy for undiagnosed exudative pleural effusion by other clinical or radiological investigations. | Procedure: Medical thoracoscopy<br>* Performing medical thoracoscopy to diagnose pleural diseases after cytological and other investigational tests.<br>* Other names: Rigid thoracoscopy for diagnosis of pleural diseases;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Accuracy of medical thoracoscopy for patients diagnosed as fibrinous pleuritis. | During 2 years after medical thoracoscopy, the diagnostic sensitivity, specificity, positive predictive value and negative predictive value are determined in the patients diagnosed as fibrinous pleuritis. | 2 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To determine the factors which point the false positive diagnosis of fibrinous pleuritis. | The factors predictive of false-negative biopsy results in the patients with a diagnosis of fibrinous pleuritis are determined by using logistic regression analysis . | 2 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Medical thoracoscopy, Pleural effusion, Malignant pleural diseases, Tuberculous pleuritis, Fibrinous pleuritis