Uniportal VATS pleural biopsy in the diagnosis of exudative pleural effusion: awake or intubated?

The aim of this study is to compare the diagnostic efficacy and safety of video-assisted thoracoscopic surgery (VATS) with awake VATS (AVATS) pleural biopsy in undiagnosed exudative pleural effusions. The diagnostic efficacy of pleural biopsy by uniportal VATS under general anesthesia or AVATS under...

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Bibliographic Details
Published in:Journal of cardiothoracic surgery 2021-04, Vol.16 (1), p.95-95, Article 95
Main Authors: Gokce, Mertol, Altinsoy, Bulent, Piskin, Ozcan, Bahadir, Burak
Format: Article
Language:English
Subjects:
Anesthesia
Awake
Biopsy
Comorbidity
Comparative analysis
Complications
Diagnosis
Diagnostic systems
Exudation
General anesthesia
Hospitals
Inflammation
Length of stay
Local anesthesia
Patients
Pleural effusion
Pleural effusions
Safety
Sensitivity analysis
Spirometry
Statistical analysis
Surgery
Thoracentesis
Thoracic surgery
Tuberculosis
Ventilation
Video-assisted thoracoscopic surgery
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Summary:The aim of this study is to compare the diagnostic efficacy and safety of video-assisted thoracoscopic surgery (VATS) with awake VATS (AVATS) pleural biopsy in undiagnosed exudative pleural effusions. The diagnostic efficacy of pleural biopsy by uniportal VATS under general anesthesia or AVATS under local anesthesia and sedation performed by the same surgeon in patients with undiagnosed exudative pleural effusion between 2007 and 2020 were retrospectively evaluated. Test sensitivity, specificity, positive predictive value and negative predictive value were compared as well as age, gender, comorbidities, procedure safety, additional pleural-based interventions, duration time of operation and length of hospital stay. Of 154 patients with undiagnosed exudative pleural effusion, 113 (73.37%) underwent pleural biopsy and drainage with VATS, while 41 (26.62%) underwent AVATS pleural biopsy. Sensitivity, specificity, positive predictive value and negative predictive value were 92, 100, 100, and 85.71% for VATS, and 83.3, 100, 100, and 78.9% for AVATS, respectively. There was no significant difference in diagnostic test performance between the groups, (p = 0.219). There was no difference in the rate of complications [15 VATS (13.3) versus 4 AVATS (9.8%), p = 0.557]. Considering additional pleural-based interventions, while pleural decortication was performed in 13 (11.5%) cases in the VATS group, no pleural decortication was performed in AVATS group, (p = 0.021). AVATS group was associated with shorter duration time of operation than VATS (22.17 + 6.57 min. Versus 51.93 + 8.85 min., p 
ISSN:1749-8090
1749-8090
DOI:10.1186/s13019-021-01461-7