Abstract:
:BACKGROUND Traditional diagnostic methods for tuberculosis (TB) cannot be reliably applied to tuberculous pleurisy. Therefore, this prospective, randomized, controlled trial was performed to compare the diagnostic sensitivity and safety of ultrasound-guided cutting-needle pleural biopsy versus thoracoscopic pleural biopsy in patients suspected of tuberculous pleurisy following inconclusive thoracentesis. MATERIAL AND METHODS A total of 196 adult patients with acid-fast bacillus (AFB)-negative exudative pleural effusions clinically suspected of tuberculous pleurisy were recruited. Enrollees were randomized into 2 cohorts: ultrasound-guided cutting-needle pleural biopsy (n=96) or thoracoscopic pleural biopsy (n=96). The overall diagnostic yields, diagnostic sensitivities for tuberculous pleurisy, and post-procedural complications for both cohorts were statistically compared. RESULTS Ultrasound-guided pleural biopsy displayed an overall diagnostic yield of 83%, while thorascopic pleural biopsy displayed a similar overall diagnostic yield of 86% (χ²=1.88, df=1, p=0.17). There were 127 patients conclusively diagnosed with tuberculous pleurisy, resulting in a tuberculous pleurisy prevalence of 65% in this patient population (66% in the ultrasound cohort vs. 63% in the thoracoscopy cohort; p>0.05). Ultrasound-guided pleural biopsy displayed a sensitivity of 82% in detecting tuberculous pleurisy, while thorascopic pleural biopsy displayed a similar sensitivity of 90% (χ²=1.05, df=1, p=0.30). The sensitivities of these 2 modalities did not significantly differ based on the degree of pleural thickening (p>0.05). Post-procedural complications were minor. CONCLUSIONS Ultrasound-guided and thoracoscopic pleural biopsy both display strong (>80%) but statistically similar overall diagnostic yields for diagnosing pleural effusions following inconclusive thoracentesis. Both modalities also display strong (>80%) but statistically similar sensitivities in detecting tuberculous pleurisy.
journal_name
Med Sci Monitjournal_title
Medical science monitor : international medical journal of experimental and clinical researchauthors
Zhou X,Jiang P,Huan X,Li W,Chen Y,Gao H,Qi X,Wu J,Wang X,Ou Y,Jia Xdoi
10.12659/MSM.912506subject
Has Abstractpub_date
2018-10-10 00:00:00pages
7238-7248eissn
1234-1010issn
1643-3750pii
912506journal_volume
24pub_type
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journal_title:Medical science monitor : international medical journal of experimental and clinical research
pub_type: 杂志文章,评审
doi:
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journal_title:Medical science monitor : international medical journal of experimental and clinical research
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journal_title:Medical science monitor : international medical journal of experimental and clinical research
pub_type: 杂志文章
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journal_title:Medical science monitor : international medical journal of experimental and clinical research
pub_type: 杂志文章
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journal_title:Medical science monitor : international medical journal of experimental and clinical research
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journal_title:Medical science monitor : international medical journal of experimental and clinical research
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journal_title:Medical science monitor : international medical journal of experimental and clinical research
pub_type: 临床试验,杂志文章
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journal_title:Medical science monitor : international medical journal of experimental and clinical research
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journal_title:Medical science monitor : international medical journal of experimental and clinical research
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journal_title:Medical science monitor : international medical journal of experimental and clinical research
pub_type: 杂志文章,多中心研究
doi:
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journal_title:Medical science monitor : international medical journal of experimental and clinical research
pub_type: 杂志文章,评审
doi:
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journal_title:Medical science monitor : international medical journal of experimental and clinical research
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journal_title:Medical science monitor : international medical journal of experimental and clinical research
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journal_title:Medical science monitor : international medical journal of experimental and clinical research
pub_type: 杂志文章
doi:
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journal_title:Medical science monitor : international medical journal of experimental and clinical research
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:Medical science monitor : international medical journal of experimental and clinical research
pub_type: 杂志文章
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