DOI: https://doi.org/10.36347/sasjs.2025.v11i01.007

Pages: 31-36

Background: Video-Assisted Thoracic Surgery (VATS) has emerged as a significant diagnostic tool for unexplained pleural effusions. This study evaluates the diagnostic yield, safety profile, and clinical utility of VATS in the investigation of pleural effusions through analysis of 50 consecutive cases. Methods: A retrospective observational study was conducted involving 50 patients who underwent VATS for unexplained pleural effusions between 1st January 2023 to 30th June 2024. All procedures were performed under local anaesthesia using single port technique. Data collected included demographic characteristics, operative findings, pathological diagnoses, complications, and outcomes. Results: The mean age of patients was 58.3 ± 15.4 years, with male predominance (64%). VATS achieved a definitive diagnosis in 47 out of 50 cases (94% diagnostic yield). Malignancy was the most common diagnosis (48%), followed by tuberculosis (24%), and non-specific pleuritis (16%). The mean operative time was 65.8±18.3 minutes. Minor complications occurred in 7 patients (14%) and major complications in 2 patients (4%), with no mortality. The mean hospital stay was 5.8 ± 2.3 days. Complete pleural visualization was achieved in 94% of cases, with one case requiring conversion to open surgery. Conclusion: VATS demonstrates high diagnostic yield and favorable safety profile in the evaluation of unexplained pleural effusions. The procedure's ability to provide direct visualization and targeted biopsies makes it particularly valuable in diagnosing malignancies and tuberculosis. These findings support the integration of VATS into the diagnostic algorithm for unexplained pleural effusions, especially when less invasive methods have failed to provide a diagnosis.