Sonographic Indicators for Treatment Choice and Follow-Up in Patients with Pleural Effusion
Aim. The aim of this study was to evaluate the role of thoracic sonography in treatment of pleural effusions and to identify sonographic indicators for surgical intervention. Materials and Methods. This study included 378 patients with pleural effusions. US characteristics of effusions as the echo s...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2018-01-01
|
| Series: | Canadian Respiratory Journal |
| Online Access: | http://dx.doi.org/10.1155/2018/9761583 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841524815020687360 |
|---|---|
| author | Ruza Stevic Nikola Colic Slavisa Bascarevic Marko Kostic Dejan Moskovljevic Milan Savic Maja Ercegovac |
| author_facet | Ruza Stevic Nikola Colic Slavisa Bascarevic Marko Kostic Dejan Moskovljevic Milan Savic Maja Ercegovac |
| author_sort | Ruza Stevic |
| collection | DOAJ |
| description | Aim. The aim of this study was to evaluate the role of thoracic sonography in treatment of pleural effusions and to identify sonographic indicators for surgical intervention. Materials and Methods. This study included 378 patients with pleural effusions. US characteristics of effusions as the echo structure and pleural thickening were analyzed. Regarding the US finding, the diagnostic or therapeutic procedure was performed. Results. The study included 267 male and 111 female patients, an average of 56.7 years. Infection was the most frequent cause of effusion. Two hundred sixty-nine patients had loculated and 109 free pleural effusion. Most frequent echo structure of loculated effusion was complex septate, whereas free effusion was mostly anechoic. Successful obtaining of the pleural fluid without real-time guidance was in 88% and under real-time guidance in 99% patients (p<0.012). There was no significant difference in success rate between free and loculated effusion and regarding the echo structure (p=0.710 and 0.126, respectively). Complete fluid removal after serial thoracentesis or drainage was achieved in 86% patients. Forty-five patients with significantly thicker pleural peel and impairment of the diaphragmatic function than remaining of the group (p<0.001) underwent surgery. Open thoracotomy and decortication was more frequently performed in patients with completely fixed diaphragm and complex, dominantly septated effusions. There is no significant difference in US parameters comparing to patients underwent VATS, but the number of VATS is too small for valid conclusion. Conclusion. Thoracic sonography is a very useful tool in the evaluation of clinical course and treatment options in patients with pleural effusions of a different origin. |
| format | Article |
| id | doaj-art-f05253954e4b48d89a1a08046bbd2543 |
| institution | Kabale University |
| issn | 1198-2241 1916-7245 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Respiratory Journal |
| spelling | doaj-art-f05253954e4b48d89a1a08046bbd25432025-02-03T05:47:22ZengWileyCanadian Respiratory Journal1198-22411916-72452018-01-01201810.1155/2018/97615839761583Sonographic Indicators for Treatment Choice and Follow-Up in Patients with Pleural EffusionRuza Stevic0Nikola Colic1Slavisa Bascarevic2Marko Kostic3Dejan Moskovljevic4Milan Savic5Maja Ercegovac6Faculty of Medicine, University of Belgrade, SerbiaCenter for Radiology and MRI, Clinical Center of Serbia, Belgrade, SerbiaFaculty of Medicine, University of Belgrade, SerbiaClinic for Thoracic Surgery, Clinical Center of Serbia, Belgrade, SerbiaClinic for Thoracic Surgery, Clinical Center of Serbia, Belgrade, SerbiaFaculty of Medicine, University of Belgrade, SerbiaFaculty of Medicine, University of Belgrade, SerbiaAim. The aim of this study was to evaluate the role of thoracic sonography in treatment of pleural effusions and to identify sonographic indicators for surgical intervention. Materials and Methods. This study included 378 patients with pleural effusions. US characteristics of effusions as the echo structure and pleural thickening were analyzed. Regarding the US finding, the diagnostic or therapeutic procedure was performed. Results. The study included 267 male and 111 female patients, an average of 56.7 years. Infection was the most frequent cause of effusion. Two hundred sixty-nine patients had loculated and 109 free pleural effusion. Most frequent echo structure of loculated effusion was complex septate, whereas free effusion was mostly anechoic. Successful obtaining of the pleural fluid without real-time guidance was in 88% and under real-time guidance in 99% patients (p<0.012). There was no significant difference in success rate between free and loculated effusion and regarding the echo structure (p=0.710 and 0.126, respectively). Complete fluid removal after serial thoracentesis or drainage was achieved in 86% patients. Forty-five patients with significantly thicker pleural peel and impairment of the diaphragmatic function than remaining of the group (p<0.001) underwent surgery. Open thoracotomy and decortication was more frequently performed in patients with completely fixed diaphragm and complex, dominantly septated effusions. There is no significant difference in US parameters comparing to patients underwent VATS, but the number of VATS is too small for valid conclusion. Conclusion. Thoracic sonography is a very useful tool in the evaluation of clinical course and treatment options in patients with pleural effusions of a different origin.http://dx.doi.org/10.1155/2018/9761583 |
| spellingShingle | Ruza Stevic Nikola Colic Slavisa Bascarevic Marko Kostic Dejan Moskovljevic Milan Savic Maja Ercegovac Sonographic Indicators for Treatment Choice and Follow-Up in Patients with Pleural Effusion Canadian Respiratory Journal |
| title | Sonographic Indicators for Treatment Choice and Follow-Up in Patients with Pleural Effusion |
| title_full | Sonographic Indicators for Treatment Choice and Follow-Up in Patients with Pleural Effusion |
| title_fullStr | Sonographic Indicators for Treatment Choice and Follow-Up in Patients with Pleural Effusion |
| title_full_unstemmed | Sonographic Indicators for Treatment Choice and Follow-Up in Patients with Pleural Effusion |
| title_short | Sonographic Indicators for Treatment Choice and Follow-Up in Patients with Pleural Effusion |
| title_sort | sonographic indicators for treatment choice and follow up in patients with pleural effusion |
| url | http://dx.doi.org/10.1155/2018/9761583 |
| work_keys_str_mv | AT ruzastevic sonographicindicatorsfortreatmentchoiceandfollowupinpatientswithpleuraleffusion AT nikolacolic sonographicindicatorsfortreatmentchoiceandfollowupinpatientswithpleuraleffusion AT slavisabascarevic sonographicindicatorsfortreatmentchoiceandfollowupinpatientswithpleuraleffusion AT markokostic sonographicindicatorsfortreatmentchoiceandfollowupinpatientswithpleuraleffusion AT dejanmoskovljevic sonographicindicatorsfortreatmentchoiceandfollowupinpatientswithpleuraleffusion AT milansavic sonographicindicatorsfortreatmentchoiceandfollowupinpatientswithpleuraleffusion AT majaercegovac sonographicindicatorsfortreatmentchoiceandfollowupinpatientswithpleuraleffusion |