Author/Authors :
Stevic, Ruza Faculty of Medicine - University of Belgrade, Serbia , Colic, Nikola Center for Radiology and MRI - Clinical Center of Serbia, Belgrade, Serbia , Bascarevic, Slavisa Clinic for oracic Surgery - Clinical Center of Serbia, Belgrade, Serbia , Kostic, Marko Clinic for oracic Surgery - Clinical Center of Serbia, Belgrade, Serbia , Moskovljevic, Dejan Clinic for oracic Surgery - Clinical Center of Serbia, Belgrade, Serbia , Savic, Milan Clinic for oracic Surgery - Clinical Center of Serbia, Belgrade, Serbia , Ercegovac, Maja Clinic for oracic Surgery - Clinical Center of Serbia, Belgrade, Serbia
Abstract :
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). *ere 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.