PROSEDUR DIAGNOSIS PADA EFUSI PLEURA UNILATERAL DENGAN PLEUROSKOPI: LAPORAN KASUS

Elsa Purnama Sari; Oea Khairsyaf; Russilawati Russilawati

doi:10.32502/sm.v12i2.3325

PROSEDUR DIAGNOSIS PADA EFUSI PLEURA UNILATERAL DENGAN PLEUROSKOPI: LAPORAN KASUS

Elsa Purnama Sari, Oea Khairsyaf, Russilawati Russilawati

Abstract

Pleuroskopi merupakan tindakan invasif minimal untuk mengakses rongga pleura sehingga membantu visualisasi langsung pada permukaan pleura. Laporan kasus ini memaparkan seorang perempuan berusia 54 tahun datang ke rumah sakit dengan keluhan utama sesak napas yang meningkat sejak 2 hari yang lalu. Sesak napas sudah dirasakan sejak 1 bulan dan pasien telah dikeluarkan cairan melalui dinding dada sebanyak 2500 cc. Pasien juga telah melalui pemeriksaan rontgen, USG dan CT-scan toraks yang menunjukkan kecurigaan pasien menderita kanker paru dengan efusi pleura dan didiagnosa banding dengan efusi pleura ec TB (pleuritis tuberculosis). Oleh karena itu pasien dilakukan prosedur diagnostik pleuroskopi untuk menegakkan diagnostik dengan tujuan melihat pleura secara langsung dan mengambil sampel jaringan. Hasil sitologi dan patologi jaringan tidak menunjukkan tanda keganasan dan gambaran pleuroskopi memberikan gambaran TB sehingga pasien ditatalaksana sebagai pleuritis tuberculosis.

Keywords

pleuroskopi, diagnostik, efusi pleura, pleuritis TB

Full Text:

PDF (Bahasa Indonesia)

References

Rasmin M, Jusuf A, Amin M, Taufik, Nawas MA, Rai IBN, et al. Buku Ajar Pulmonologi dan Kedokteran Respirasi. Jakarta: Penerbit Universitas Indonesia; 2017. p. 423–8.

Alraiyes AH, Dhillon SS, Harris K, Kaphle U, Kheir F. Medical Thoracoscopy. Pleura. 2016;3:1-11.

Ali MS, Light RW, Maldonado F. Pleuroscopy or video-assisted thoracoscopic surgery for exudative pleural effusion: A comparative overview. J Thorac Dis. 2019;11(7):3207–16.

McDonald CM, Pierre C, de Perrot M, Darling G, Cypel M, Pierre A, et al. Efficacy and Cost of Awake Thoracoscopy and Video-Assisted Thoracoscopic Surgery in the Undiagnosed Pleural Effusion. Ann Thorac Surg. 2018;106(2):361–7.

Khan FY, Alsamawi M, Yasin M, Ibrahim AS, Hamza M, Lingawi M, et al. Etiology of pleural effusion among adults in the state of Qatar: A 1-year hospital- based study. East Mediterr Heal J. 2011;17(7):611–8.

Yovi I, Anggraini D, Ammalia S. Hubungan Karakteristik dan Etiologi Efusi Pleura di RSUD Arifin Achmad Pekanbaru. Univ Riau. 2017;37(2):135–44.

Wan YY, Zhai CC, Lin XS, Yao ZH, Liu QH, Zhu L, et al. Safety and complications of medical thoracoscopy in the management of pleural diseases. BMC Pulm Med. 2019;19(1):1–8.

Prabhu VG, Narasimhan R. The role of pleuroscopy in undiagnosed exudative pleural effusion. Lung India. 2012;29(2):128– 30.

Murthy V, Bessich JL. Medical thoracoscopy and its evolving role in the diagnosis and treatment of pleural disease. J Thorac Dis. 2017;9(2):S1011–21.

Casalini AG, Mori PA, Majori M, Anghinolfi M, Silini EM, Gnetti L, et al. Pleural tuberculosis: medical thoracoscopy greatly increases the diagnostic accuracy. ERJ Open Res [Internet]. 2018;4(1):00046–2017.

Lin MT, Wang JY, Yu CJ, Lee LN, Yang PC. Mycobacterium tuberculosis and polymorphonuclear pleural effusion: Incidence and clinical pointers. Respir Med. 2009;103(6):820–6.

Lin CM, Lin SM, Chung FT, Lin HC, Lee KY, Huang C Da, et al. Amplified mycobacterium tuberculosis direct test for diagnosing tuberculous pleurisy-a diagnostic accuracy study. PLoS One. 2012;7(9):1–7.

Hooper C, Lee YCG, Maskell N. Investigation of a unilateral pleural effusion in adults: British Thoracic Society pleural disease guideline 2010. Thorax. 2010;65: 4-14

Loddenkemper R, Lee P, Noppen M, Mathur PN. Medical thoracoscopy/ pleuroscopy: Step by step. Breathe. 2011;8(2):157–67.

Agarwal R, Aggarwal AN, Gupta D. Diagnostic accuracy and safety of semirigid thoracoscopy in exudative pleural effusions: A meta-analysis. Chest. 2013;144(6):1857– 67.

Dhooria S, Singh N, Aggarwal AN, Gupta D, Agarwal R. A randomized trial comparing the diagnostic yield of rigid and semirigid thoracoscopy in undiagnosed pleural effusions. Respir Care. 2014;59(5):756–64.

Lee CS, Li SH, Chang CH, Chung FT, Chiu LC, Chou CL, et al. Diagnosis of tuberculosis pleurisy with three endoscopic features via pleuroscopy. Ther Adv Respir Dis. 2021;15:1–8.

Thomas M, Ibrahim WH, Raza T, Mushtaq K, Arshad A, Ahmed M, et al. Medical thoracoscopy for exudative pleural effusion: An eight-year experience from a country with a young population. BMC Pulm Med. 2017;17(1):10–4.

Light RW. Pleural Disease. In: 5th ed. Wolters Kluwer; 2007. p. 109–11.

Helala LA, El-Assal GM, Farghally AA, El Rady MMA. Diagnostic yield of medical thoracoscopy in cases of undiagnosed pleural effusion in Kobri El-Kobba Military Hospital. Egypt J Chest Dis Tuberc. 2014;63(3):629–34

Rodrigues L V., Samouco G, Gomes R, Santos C, Ferreira L. Effectiveness and safety of local anesthetic, semi-flexible pleuroscopy – experience from a peripheral hospital. Pulmonology. 2019;25(1):9–14.

Mercer RM, Corcoran JP, Porcel JM, Rahman NM, Psallidas I. Interpreting pleural fluid results. Clin Med J R Coll Physicians London. 2019;19(3):213–7.

Cibas ES, Ducatman BS. Cytology: Diagnostic Principles and Clinical Correlates. Fifth. Ch.4, Pleural, Pericardial and Peritoneal Fluids.Philadelphia: Elsevier; 2021. p 141-145.

Rao N, Moran CA. Pulmonary Pathology. 1st ed. Ch.1 ,Infection. New York: Demos Medical Publishing; 2014. p. 14-17.

Kong XL, Zeng HH, Chen Y, Liu TT, Shi ZH, Zheng DY, et al. The visual diagnosis of tuberculous pleuritis under medical thoracoscopy: A retrospective series of 91 cases. Eur Rev Med Pharmacol Sci. 2014;18(10):1487–9

DOI: https://doi.org/10.32502/sm.v12i2.3325