The role of thoracoscopy in the diagnosis of pleurisy

Background
Thoracoscopic intervention in pleural abscesses is a minimally invasive, safe and effective procedure. It allows the connection of the hollow chamber, decortication, the restoration of lung respiratory mobility and thus the shortening of the patient's treatment time. Moreover, histopathological examination of the collected material allows to make the final diagnosis.

Objective
Evaluation of the role of thoracoscopy in the diagnosis of tuberculosis in patients with pleural effusion.

Material and methods
In 2008-2016, 59 patients with pleural abscess were treated with thoracoscopic procedures. On the basis of histopathological examination of pleural sections, 9 of them were diagno¬sed with tuberculosis. In the group of children with tuberculosis, there were 8 boys and 1 girl, aged 4 to 17 years. Results:

Results
The main symptoms were chest pain and shortness of breath. 4 out of 9 patients had normal levels of inflammatory markers. In addition to chest X-ray examination, 7 additional patients had a CT scan. Six patients underwent left-sided thoracoscopy, 3 right-sided. Apart from the presence of fluid, lung deficiency, pleural thickening and pneumothorax have been reported. In 4 cases, subcapsular lesions were found. All patients were excised from the pleural wall and/or lung for histopathological examination, based on tuberculosis. This enabled the rapid implementation of pharmacological treatment.

Conclusions
Tuberculosis is still a current clinical problem. Negative inflammatory factors do not exclude the active tuberculosis process. Imaging studies are not specific to the diagnosis of tuberculosis. Thoracoscopy gives you the opportunity to evaluate the lung and lung cavity and to take material for histopathologi¬cal examination - which, in the case of a tuberculosis test, allows for proper and specific treatment.