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Ultrasound guided pleural brushing: anew method for obtaining pleural specimen in malignant effusion

مؤلف البحث
GamalAgmy
,YousefAhmed
,AlaaTHassan
مجلة البحث
Egyptian Journal of Chest Diseases and Tuberculosis www.elsevier.com/locate/ejcdtwww.sciencedirect.com
المشارك في البحث
الناشر
Egyptian Journal of Chest Diseases and Tuberculosis www.elsevier.com/locate/ejcdtwww.sciencedirect.com
تصنيف البحث
1
عدد البحث
NULL
موقع البحث
NULL
سنة البحث
2016
صفحات البحث
NULL
ملخص البحث

Chest Department,AssiutUniversity,Assiut,Egypt

Abstract Purpose: Encouraging positive diagnosticyieldsin malignantpleuraleffusion couldbeobtainedbypleuralbrushingperformedthroughtwotechniques,thefirstwasclosedandthesecondwasthoracoscopic.Untilnowtheultrasoundguidedpleuralbrushingisnotincludedwithinthesetechniquesanditsdiagnosticyield therefore is notevaluated.Sotheaim of thisstudywasto evaluatethe diagnosticyield of
thisprocedureanditscontributionsasatechniquenotusedpreviouslyintheinterventionalpulmonologypracticetoobtainpleuralspecimenforcytologicalexaminationinmalignantpleuraleffusion.Methods:ThisprospectiveinterventionalstudywasconductedintheChestDepartment–AssiutUniversityHospitalduringtheperiod from July2014to September2015.Patientswhohadhighlysuspiciousmalignantpleural effusion(clinical,radiological,andlaboratory)werehospitalizedandenrolledinthisstudy.Patientswithbleedingtendencyorcoagulationprofileabnormalitieswereexcludedfromthestudy.Patientswerealsoexcludedfromthisstudyiftheetiologyofeffusionwasprovedtobebenign.Informedwrittenconsentwasobtainedfromallpatients.Theequipmentusedinourstudywereultrasoundapparatus(ALOKA–Prosound–SSD–3500SV),biopsyforceps(KARL–STORZ–Germany10329L–BS),thebronchoscopiccleaningbrush(PENTAX CS6002SN) trocar andcannula of Cope’sneedle and the semirigidthoracoscope(LTF; Olympus;Tokyo,Japan).Thoracentesis,pleuralbrushingandbiopsyforcepsofthepleurawereperformedforallenrolledpatientsintheultrasoundunitoftheChestDepartmentwhilethoracoscopywasdoneintheendoscopyunitonlyforpatientsinwhomthediagnosiscouldnotbeachievedbytheseprocedures.Results:Among22patientswhowerefinallydocumentedtohavemalignancy,theultrasoundguidedpleuralbrushingprovideddiagnosisin9(41%)/22cases,itwasexclusivelydiagnosticin3patients.Interestingly,theyieldof thisprocedurehad its contributionsregardingthefinalpathologicaldiagnosisof ourcases,itcouldaugmentthepositiveyieldtobe55%insteadof41%(forpleuralfluidcytologyalone),82%insteadof68%(forbiopsyforcepsalone)and86%insteadof72%(forbothfluidcytologyandforcepsbiopsy).Therecordedcomplicationsinourstudywereminimalandnotassociatedwithanymortality.Conclusions:Ultrasound-guidedpleuralbrushingisanewmethodforobtainingpleuralspecimens.Itisasimpleandrelativelysafeprocedure.Thistechniqueprovidesadditionaldiagnosticyieldin malignantpleuraleffusion.Werecommend itbesideothersin our diagnosticpracticeforsuspiciousmalignanteffusionespeciallywhenthoracoscopy is notavailable.