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Background: Transthoracic ultrasound (TUS) has been established to be important in chest diseases including pleural diseases. Interventional pulmonology showed rapid growth and flex–rigid thoracoscopy development, which brought medical thoracoscopy to the forefront. Objective: To compare the diagnostic accuracy, advantages and complications of TUS pleural biopsies versus medical thoracoscopic pleural biopsies in patients with idiopathic and exudative pleural effusion (PE) in El-Minia University Hospital. Patients and methods: Seventy patients with idiopathic and exudative PE were divided randomly into two groups; group I included 45 patients underwent sonar guided pleural biopsy and group II involved 25 patients underwent thoracoscopic pleural biopsy. Results: TUS-guided biopsy was diagnostic in 40 of 45 (88.8%) compared to 24 of 25 cases (96%) were diagnosed by thoracoscopy. Forty-two patients had malignant cause of effusion; 23 patients (51%) in TUS group and 19 (76%) patients in thoracoscopy group. Twenty-two patients had nonmalignant pleural effusion; 17 in group I and 5 in group II. The diagnosis was unclear in 6 patients, 5 of them in group I. Thoracoscopic group displayed greater percentages of post-procedural complications especially pain in site of puncture. Conclusion: TUS examination has close sensitivity and specificity to medical thoracoscopy and allows better assessment of effusion with fewer complications.

the egyptian journal of hospital medicine

Diagnostic Accuracy of Transthoracic Ultrasound Guided Biopsy Versus Medical Thoracoscopic Pleural Biopsies in Unexplained Exudative Pleural Effusions in El-Minia University Hospital (Single Center Experience)