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The role of video-assisted thoracoscopy in the diagnosis of the causes of pleural effusions

دور تنظير الصدر بمساعدة الفيديو في تشخيص أسباب انصباب الجنب

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 Publication date 2017
  fields Medicine
and research's language is العربية
 Created by Shamra Editor




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The diagnosis of pleural diseases is one of the frequent clinical problems. Despite a variety of diagnostic tests are available for evaluating pleural effusions, approximately 15– 20% of pleural effusions remains undiagnosed, In this cases ,a thoracoscopy plays an important role, it permits the surgeon to visually view and evaluate the entire pleural space ,and to obtain enough accurate biopsies from suspected areas. This study aims to evaluate the effectivenes of Video Assisted Thoracoscopic surgery (VATS) in diagnosis of pleural effusions. Between June 2012 and June 2015 we performed 38diagnostic thorososcopy for undiagnosed pleural effusions. The histopathologic studies of pleural biopsies result were as follows : )%60,5 ( malignancies,)%31,6 ( TB And )%7,9 ( nonspecific inflammatory reaction. The malignant diseases are: Mesothelioma )%60,9(, Metastases of adenocarcinoma )%30,4(,Lymphoma )% 8,7( 4 Complications ,with no mortality. Conclusion: Video Assisted Thoracoscopic Surgery is a safe and accurate diagnostic procedure for pleural diseases but it also has a very useful role in therapy.(VATS) saves time, effort and cost, more over it is preferred by the patient as he recovers and returns to his normal activity rapidly.


Artificial intelligence review:
Research summary
تناولت هذه الدراسة دور تنظير الصدر بمساعدة الفيديو (VATS) في تشخيص أسباب انصبابات الجنب الغامضة، والتي لم يتمكن الأطباء من تشخيصها باستخدام الفحوصات غير الباضعة مثل بزل الجنب وخزعة الجنب عبر الجلد. أجريت الدراسة على 38 مريضًا في مستشفى الأسد الجامعي باللاذقية بين يونيو 2012 ويونيو 2015. أظهرت النتائج أن 60.5% من الحالات كانت آفات خبيثة، و31.6% كانت تدرنًا جنبيًا، بينما كانت 7.9% التهابات غير نوعية. أكدت الدراسة على فعالية وسلامة VATS في تشخيص أمراض الجنب، حيث لم تحدث أي وفيات وظهرت مضاعفات في أربع حالات فقط. توصي الدراسة بإدخال VATS كخطوة تشخيصية أولى في حالات انصباب الجنب غير المشخصة.
Critical review
دراسة نقدية: تعتبر هذه الدراسة من الدراسات الهامة التي تسلط الضوء على فعالية وسلامة تقنية تنظير الصدر بمساعدة الفيديو في تشخيص أمراض الجنب. ومع ذلك، هناك بعض النقاط التي يمكن تحسينها. أولاً، كان من الأفضل تضمين عينة أكبر من المرضى لزيادة موثوقية النتائج. ثانيًا، لم يتم التطرق بشكل كافٍ إلى العلاقة بين التعرض لمادة الأسبستوس وظهور الميزوتليوما، وهو موضوع يستحق المزيد من البحث والتوثيق. أخيرًا، كان من الممكن تقديم المزيد من التفاصيل حول الإجراءات المتبعة في حالة حدوث مضاعفات وكيفية التعامل معها بشكل أكثر تفصيلًا.
Questions related to the research
  1. ما هي نسبة الحالات التي كانت آفات خبيثة في الدراسة؟

    60.5% من الحالات كانت آفات خبيثة.

  2. ما هي الفئات العمرية التي شملتها الدراسة؟

    تراوحت أعمار المرضى بين 17 و73 سنة.

  3. ما هي نسبة المضاعفات التي حدثت خلال الدراسة؟

    حدثت مضاعفات في 10.5% من الحالات.

  4. ما هي التوصيات التي قدمتها الدراسة بشأن استخدام VATS؟

    أوصت الدراسة بإدخال VATS كخط تشخيصي وعلاجي أول في حالات انصباب الجنب غير المشخصة ببزل الجنب وخزعة الجنب العمياء بالإبرة.


References used
VIDEO-ASSISTED THORACIC SURGERY (VATS). TODD L. DEMMY, M.D. University of Missouri-Columbia, Ellis Fischel Cancer Center Columbia, Missouri, U.S.A.2005
DIETER, RS. The History of Thoracoscopy. In: Dieter RA, ed. Thoracoscopy for Surgeons: Diagnostic and Therapeutic. New York: Igaku-Shoin; 1995: 1-10
DEMMY TL, CURTIS JJ, BOLEY TM et al. Diagnostic and therapeutic thoracoscopy lessons from the learning curve. Am J Surg 1993; 166:696-700
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