Polish Journal of Thoracic and Cardiovascular Surgery
eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
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1/2025
vol. 22
 
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abstract:
Original paper

The diagnostic value of thoracic ultrasound in thoracic surgery consultations: a new tool in pleural effusion decision-making

Burcu Kılıç
1
,
Yaman Khoraki
1
,
Ömer Faruk Sağlam
2
,
Gizem Özçıbık Işık
3
,
Tolunay Turan
1
,
Ezel Erşen
1
,
H. Volkan Kara
1
,
Akif Turna
1
,
Kamil Kaynak
1

  1. Department of Thoracic Surgery, Istanbul University – Cerrahpasa, Istanbul, Turkey
  2. Thoracic Surgery, Tokat State Hospital, Tokat, Turkey
  3. Thoracic Surgery, Bolu İzzet Baysal State Hospital, Bolu, Turkey
Kardiochirurgia i Torakochirurgia Polska 2025; 22 (1): 1-7
DOI: https://doi.org/10.5114/kitp.2025.148550
Online publish date: 2025/03/17
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Introduction:
Thoracic ultrasound (US) is a practical tool in radiology that has been commonly used for decades. Its daily clinic use in thoracic surgery is rising, and scientific evidence is needed to support its use.

Aim:
We aimed to determine the diagnostic value of handheld, portable thoracic ultrasound scanning (HH-US) in patients referred to the thoracic surgery outpatient clinic with suspected pleural effusion and compare the diagnostic role with chest X-rays (CXR) or computed tomography (CT).

Material and methods:
We analyzed the patients between 2020 and 2023 who were referred to our outpatient clinic with various symptoms and having differential diagnosis of pleural effusion. In total, 91 patients fulfilled the inclusion criteria. Ultrasonographic (US) scans were performed by thoracic surgeons who were educated and certified in ultrasonography training. All patients underwent US first and then were referred for chest X-ray or computed tomography. All the results were compared focusing on the efficacy of US initially. If the amount of the effusion required drainage, thoracentesis was carried out with US support. The indications, methods, time, and related complications, with demographic data of the patients were recorded and analyzed.

Results:
There were 57 (62.6%) male and 34 female (37.4%) patients. Only diagnostic thoracentesis was performed in 16 patients, catheter thoracostomy was performed in 47 patients, minimal effusion not requiring pleural intervention was observed in 6 patients (2 patients were trauma patients who applied to the emergency department), minimal effusion was detected in 14 patients, and no intervention was performed. No complications were observed. The sensitivity of US in detecting fluid effusion compared to CXR was 83.3%, while its sensitivity compared to thorax computed tomography (CT) was 88.5%.

Conclusions:
Proficient thoracic surgeons can effectively employ ultrasound devices for diagnosing and managing pleural effusions. This would be helpful for decision making and treatment.

keywords:

pleural effusion, thoracic ultrasound (US), pleural catheter, thoracentesis
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