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Clinical long-term outcome of non-specific pleuritis (NSP) after surgical or medical thoracoscopy

BACKGROUND: Thoracoscopy, either “medical” or “surgical”, is the gold standard to reveal the cause of pleural effusion by taking large biopsies. However, in some cases, the histology of pleural biopsies is inconclusive for a specific cause, describing a variable process of inflammation, encompassing...

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Autores principales: Karpathiou, Georgia, Anevlavis, Stavros, Tiffet, Olivier, Casteillo, Francois, Mobarki, Mousa, Mismetti, Valentine, Ntolios, Paschalis, Koulelidis, Andreas, Trouillon, Tiffany, Zadel, Nicolas, Hathroubi, Sirine, Peoc’h, Michel, Froudarakis, Marios E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330408/
https://www.ncbi.nlm.nih.gov/pubmed/32642113
http://dx.doi.org/10.21037/jtd-19-3496
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author Karpathiou, Georgia
Anevlavis, Stavros
Tiffet, Olivier
Casteillo, Francois
Mobarki, Mousa
Mismetti, Valentine
Ntolios, Paschalis
Koulelidis, Andreas
Trouillon, Tiffany
Zadel, Nicolas
Hathroubi, Sirine
Peoc’h, Michel
Froudarakis, Marios E.
author_facet Karpathiou, Georgia
Anevlavis, Stavros
Tiffet, Olivier
Casteillo, Francois
Mobarki, Mousa
Mismetti, Valentine
Ntolios, Paschalis
Koulelidis, Andreas
Trouillon, Tiffany
Zadel, Nicolas
Hathroubi, Sirine
Peoc’h, Michel
Froudarakis, Marios E.
author_sort Karpathiou, Georgia
collection PubMed
description BACKGROUND: Thoracoscopy, either “medical” or “surgical”, is the gold standard to reveal the cause of pleural effusion by taking large biopsies. However, in some cases, the histology of pleural biopsies is inconclusive for a specific cause, describing a variable process of inflammation, encompassing for non-specific pleuritis (NSP). Questions are raised whether the surgical (or video-assisted thoracoscopic surgery, VATS) is doing better than the medical thoracoscopy (MT or pleuroscopy), but no direct comparison between the two techniques exist in the current bibliography. The aim of our retrospective study was to compare these two techniques to find whether there is any difference in the false negative cases of NSP. METHODS: We included in our study 295 patients with NSP, 179 patients who underwent VATS comparing to 116 patients who underwent MT for pleural effusion of initially undetermined cause, having a follow-up of at least one year. Analysis of patients’ files, history, clinical examinations, further tests, and follow-up were recorded. RESULTS: The mean age of our patients was 58.5±19.1 and M/F gender was 216/79; no difference was observed between the two groups. The mean follow-up period was 47.3±20.7 months. After VATS, only one patient (0.55%) was finally diagnosed with pleural malignancy (false negative) while after MT 2 patients (1.7%). Negative predictive value for pleura-related malignancy for VATS was 0.994 and for MT 0.982. CONCLUSIONS: In patients with histological diagnosis of NSP both VATS and MT showed similar and excellent results of false negative cases and negative predictive value in excluding malignant pleural disease.
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spelling pubmed-73304082020-07-07 Clinical long-term outcome of non-specific pleuritis (NSP) after surgical or medical thoracoscopy Karpathiou, Georgia Anevlavis, Stavros Tiffet, Olivier Casteillo, Francois Mobarki, Mousa Mismetti, Valentine Ntolios, Paschalis Koulelidis, Andreas Trouillon, Tiffany Zadel, Nicolas Hathroubi, Sirine Peoc’h, Michel Froudarakis, Marios E. J Thorac Dis Original Article BACKGROUND: Thoracoscopy, either “medical” or “surgical”, is the gold standard to reveal the cause of pleural effusion by taking large biopsies. However, in some cases, the histology of pleural biopsies is inconclusive for a specific cause, describing a variable process of inflammation, encompassing for non-specific pleuritis (NSP). Questions are raised whether the surgical (or video-assisted thoracoscopic surgery, VATS) is doing better than the medical thoracoscopy (MT or pleuroscopy), but no direct comparison between the two techniques exist in the current bibliography. The aim of our retrospective study was to compare these two techniques to find whether there is any difference in the false negative cases of NSP. METHODS: We included in our study 295 patients with NSP, 179 patients who underwent VATS comparing to 116 patients who underwent MT for pleural effusion of initially undetermined cause, having a follow-up of at least one year. Analysis of patients’ files, history, clinical examinations, further tests, and follow-up were recorded. RESULTS: The mean age of our patients was 58.5±19.1 and M/F gender was 216/79; no difference was observed between the two groups. The mean follow-up period was 47.3±20.7 months. After VATS, only one patient (0.55%) was finally diagnosed with pleural malignancy (false negative) while after MT 2 patients (1.7%). Negative predictive value for pleura-related malignancy for VATS was 0.994 and for MT 0.982. CONCLUSIONS: In patients with histological diagnosis of NSP both VATS and MT showed similar and excellent results of false negative cases and negative predictive value in excluding malignant pleural disease. AME Publishing Company 2020-05 /pmc/articles/PMC7330408/ /pubmed/32642113 http://dx.doi.org/10.21037/jtd-19-3496 Text en 2020 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Karpathiou, Georgia
Anevlavis, Stavros
Tiffet, Olivier
Casteillo, Francois
Mobarki, Mousa
Mismetti, Valentine
Ntolios, Paschalis
Koulelidis, Andreas
Trouillon, Tiffany
Zadel, Nicolas
Hathroubi, Sirine
Peoc’h, Michel
Froudarakis, Marios E.
Clinical long-term outcome of non-specific pleuritis (NSP) after surgical or medical thoracoscopy
title Clinical long-term outcome of non-specific pleuritis (NSP) after surgical or medical thoracoscopy
title_full Clinical long-term outcome of non-specific pleuritis (NSP) after surgical or medical thoracoscopy
title_fullStr Clinical long-term outcome of non-specific pleuritis (NSP) after surgical or medical thoracoscopy
title_full_unstemmed Clinical long-term outcome of non-specific pleuritis (NSP) after surgical or medical thoracoscopy
title_short Clinical long-term outcome of non-specific pleuritis (NSP) after surgical or medical thoracoscopy
title_sort clinical long-term outcome of non-specific pleuritis (nsp) after surgical or medical thoracoscopy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330408/
https://www.ncbi.nlm.nih.gov/pubmed/32642113
http://dx.doi.org/10.21037/jtd-19-3496
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