Perm Medical JournalPerm Medical Journal0136-14492687-1408Eco-Vector678210.17816/pmj34220-25Research ArticleDIAGNOSTIC AND THERAPEUTIC OPPORTINITIES OF VIDEOTHORACOSCOPY IN PLEURAL EFFUSION OF DIFFERENT ETIOLOGYPlaksinS Asplaksin@mail.ruFarshatovaL I-15042017342202511072017Copyright © 2017, Plaksin S.A., Farshatova L.I.2017Aim. To estimate the diagnostic and therapeutic value of videothoracoscopy in patients with pleural effusions (PE) of different etiology. Materials and methods. The experience of surgical treatment of 244 patients, who underwent videothoracoscopy (VTS) for pleural effusions of different etiology, was summarized. Results. Etiology of exudative pleurisy was rather various, however, in 110 patients (45,1 %) exudation accumulation was caused by malignant tumors. Pleurisy of inflammatory genesis was detected in 93 (38,1 %) cases including 38 cases of specific etiology. Noninflammatory pleurisies were diagnosed in 18 (7,4 %) cases. Fifteen patients (6,1 %) with pancreatogenic pleurisies and eight patients (3,3 %) with transsudates (cardiogenic, hepatogenic, nephrogenic) formed separate groups. Conclusions. Diagnostic videothoracoscopy is the method of choice in differential diagnosis of pleural effusions of different genesis and are efficient in 97,1 % of cases. Videothoracoscopy permits to state the cause of exudative pleurisy more precisely owing to visualization of changes in the pleura and possibility to obtain histological verification of diagnosis.Videothoracoscopypleural effusionchemical pleurodesisВидеоторакоскопияплевральный выпотхимический плевродез[Афанасьев С.Г., Августинович А.В., Волков М.Ю. Видеоторакоскопия как метод дифференциальной диагностики внутригрудных новообразований. Сибирский онкологический журнал 2010; 2: 9-10.][Борисов А.Е., Кубачев К.Г., Лишенко В.В., Зайцев Д.А., Заркуа Н.Э., Михайлов В.И. Торакоскопия в верификации и лечении синдрома плеврального выпота в условиях многопрофильного стационара. Вестник хирургии 2011; 170 (1): 63-65.][Клименко В.Н., Чайка О.В., Семиглазов В.В., Николаев Г.В., Ветюгов Д.Н. Видеоторакоскопия в диагностике опухолевых плевритов. Ученые записки Санкт-Петерб. гос. мед. ун-та им. акад. И.П. Павлова 2009; 16 (1): 45-48.][Трахтенберг А.Х., Соколов В.В., Пикин О.В. Возможности видеоторакоскопии в онкологической клинике. Российский онкологический журнал 2007; 4: 7-12.][Chrysanthidis M.G., Janssen J.P. Auto-fluorescence videothoracoscopy in exudative pleural effusions: preliminary results. Eur Respir J 2005; 26 (6): 989-992.][Laws D., Neville E., Duffy J. BTS guidelines for the insertion of a chest drain on behalf of the British Thoracic Society. Thorax 2003; 58: 1153-1159.][Sahn S.A. Pleural diseases related to metastatic malignancies. European Respiratory J 1997; 10: 1907-1913.][Suárez P.M., Gilart J.L. Pleurodesis in the treatment of pneumothorax and pleural effusion. Monaldi archives for chest disease J 2013; 79 (2): 81-86.][Yoon D.W., Cho J.H., Choi Y.S. Predictors of survival in patients who underwent video-assisted thoracic surgery talc pleurodesis for malignant pleural effusion. Thoracic Cancer J 2016; 7 (4): 393-398.][Wilsher M.L., Veale A.G. Medical thoracoscopy in the diagnosis of unexplained pleural effusion. Respirology 1998; 3 (2): 77-80.]