ULTRASOUND (US) GUIDED DIAGNOSTIC PROCEDURES AND MALIGNANT PLEURAL EFFUSIONS

Girolamo Geraci, Gerlando Cocchiara, Manuela Palazzolo, Aurelio Cajozzo

Department of Surgical, Oncological, Stomatological Disciplines, University of  Palermo 

Introduction: Malignant pleural effusion (PE) is a rather frequent complication of several intrathoracic and extrathoracic tumors and has an incidence of about 660 patients per million inhabitants per year.

Materials and methods: We retrospectively studied (2000 to 2018) the utility of US guided percutaneous puncture (PP) of PE, in the diagnosis/therapy of 121 patients (67 women and 54 men) with PE and suspected malignant neoplasm, mean age 52 years (39-78 years),

Results: The diagnostic accuracy of the US guided PP fluid examination, (diagnoses of malignant PE), was 91.7% (111/121), with sensitivity of 89.5% (86/96) and specificity of 100%. (25/25). 10 patients did not have confirmation of malignant PE with US guided PP; the malignancy diagnosis was obtained by biopsy with other surgical procedure.

Conclusions: The use of chest US has allowed us to reduce procedure time, hospital stay, with a significant reduction in healthcare costs, and to obtain a particularly high diagnostic accuracy with good patient compliance. We did not observe major complications during US guided PP; minor complications were found in 16.9% (14 cases) with the presence of mild chest pain.