1. THE FIRST STEP IN EVALUATING THE RESULTS OF ENDOSCOPIC PLEURAL HOSES IN THE DIAGNOSIS OF DISEASE IN TUBERCULOSIS and LUNG DISEASE HOSPITAL in HAI PHONG 2017
Vu Ngoc Truong 1
Mac Huy Tuan1
Nguyen Tuan Anh1
Nguyen Dinh Thai2
Nguyen Lam Hoa3
1Tuberculosis and Lung Hospital in Hai Phong
2Thai Binh University of Medicine and Pharmacy
3Hai Phong University of Medicine and Pharmacy

2. Pleural effusion is a common clinical syndrome
Diagnosis of clinical and subclinical (X-ray, ultrasound, suturing, etc.) is not difficult, but the diagnosis of pleural effusion’s causes have many difficulties.
In addition to classic method to diagnosis pleural effusin, such as biopsy of pleural fluid, lung cell membrane, pleural biopsy (blinded or under ultrasound guidance) results in 80% of the diagnosis, but 20-25% pleural effusion has not been diagnosed.
In these cases, pleural endoscopy provides further diagnostic accuracy with up to 90% of cases of pleural effusion particularly malignant pleural effusion.

3. Background
In Hai Phong, rigid catheter laparoscopy has been performed in a number of hospitals. This procedure requires general anesthesia, performed in the operating room. Flexible pleural fibrotic laparoscopy has been performed in many developed countries around the world, in central hospitals (Central Lung Hospital). This technique allows direct observation on the screen of pleural, lung, and mediastinal lesions - biopsy of suspected lesions; at the same time this is a safe penetration procedure, less complications. Tuberculosis and pulmonary tuberculosis patients undergoing laparoscopic lung fibrosis under the technical transfer of the Central Lung Hospital have increased the quality of diagnosis and treatment of pleural diseases.

4. Objectives
To describe the clinical and laboratory characteristics and initial assessment of soft lung endoscopic laparoscopic pleural endoscopic diagnosis in Hai Phong Tuberculosis and Lung Disease Hospital from March 2017 to August 2017.

5. RESEARCH METHODS
Study subjects: All 28 patients were enrolled and performed soft lung endoscopy at Tuberculosis and Lung Disease Hospital in Hai Phong from March 2017 to August 2017.
Method: Describe cross-sectional, prospective.
Sample: Include all patients with unexplained pleural effusion with standardized study (n = 28). Select the template according to the sampling technique is not accurate capacity with convenient form.

6. RESEARCH METHODS study of clinical characteristics,
subclinical characteristics of the study subjects;
laparoscopy results.

7. RESEARCH RESULTS Characteristics of age and sex of the research object
Male
Female
Total n %
20-30 3
13,1 2
40,0 5
17,86
30-40 4
17,3
60,0 7 25
40-50
0,0
10,71
50-60 8
34,8
28,57
>60
21,7 23
100 28
Average
45,7
46,8
45,9
Comment: the average age for both genders is 45.9; Of which 82.2% male; women 17.8%. According to Vu Khac Dai (2016) mean age of 56.1 years; us 63%; 36.3% female.

8. Common clinical symptoms
Comment: the common symptoms of 3 syndrome reduce 100%; chest pain 96.4%; breathlessness 96.4%; cough 89.2%. According to Vu Khac Dai: three reduced 100%; breathlessness 94.6%, chest pain 72.3%.

9. Location pleural effusion
Comment: Right 57.1%; left 42.9%. Rozman (2013) right 59.5%; left 40.5%. Nguyen Huy Dung right 56.5%; left 43%.

10. Characteristics of lesions on ultrasound
Comment: 100% Free pleural effusion lesions; 71.4% of Fibrin wall; 67.9% of focal epidemics. Vu Khac Dai (2016), n = 130 Free pleural effusion 96.9%; Localized 3.1%

11. Color of pleural fluid
Comment: The vast majority of cases of lemon yellow were 67.9%; dark gold 25%; pink 7.1%. Villena (2004) n = 715 lemons 53%; pink 27%; red blood 8%

12. Protein pleural fluid
Protein n %
<30 g/l
30-40
40-50 2
7,1
50-60 15
53,6
>60 11
39,3
Average
57,6
Comments: Protein average 57.6%; > .50 g / l 92.9%. Mootha (2011) protein averaged 48.9 g / l

13. Opening pleural position
Frequency %
Intercostal IV 9
32,1
Intercostal V 19
67,8
Anterior axillary line 3
10,7
Central axillary line 2
7,2
Posterior axillary line 23
82,1
Comments: Central axillary line 82.1%; intercostal V 67.8%; intercostal IV 32.1%.

14. Lung pleural injury through laparoscopy
Injure
Cancer
Tuberculosis
Inflammation
Total
n=3 %
n=20
n=5
n=28
Infiltration 3
100 2 10 5
17,9
Small dot scattered 1
33,3 7 35 8
25,6
Thick pleura 12 60
42,9
Congestive 11 55
39,3
Tumor
10,7
Fibrin wall 17 85
60,7
Sticky pleura 15 75
53,6
Comment: Fibrin wall fracture 60.7%; stick pleural 53.6%; thick pleural 42.9%; In which the tuberculosis group suffered 85% fibin walls, 75% sticky pleural, 60% thick pleural, and congestion 55%. The lung inflammation 100% syndrome is Fibrin wall and pleural mesothelioma. Cancers of pleura: 100% infectious, 100% tumor, 33,3% scattered.

15. Results of endoscopic biopsy pleural%
Tuberculosis 20
71,5
Cancer 3
10,7
Chronic inflammation 5
17,8
Total 28
100
Comments: Tuberculosis 71.5%; chronic inflammation 17.8%; cancer 10.7%
Vu Khac Dai (2016) n = 130; cancer 63.8%; tuberculosis 26.9%, inflammation 3.9%

16. Common complications of endoscopic pleural
Catastrophe
Frequency %
Pain at opening position 11
39,2
Fever 1
3,5
Bleeding
0,0
Pneumothorax and subcutaneous gas 3
10,7
Comments: Pain at open position 39.2%; pneumothorax + subcutaneous gas 10.7%; 3.5% fever. Vu Khac Dai; 60.8% chest pain; fever 4.8%; bleeding 3.1%.

17. CONCLUSION
Through study 28 patients with soft lung endoscopy at Tuberculosis and Lung Disease Hospital in Hai Phong from March 2017 to August 2017 found that:
Clinical characteristics, subclinical characteristics of subjects studied
Average age: Gender: male accounted for 82.2%; female 17.8%
Common clinical symptoms: dry cough 89.3%; chest pain 96.4%; breathlessness 96.4%; 3 reduced by 100%; cough sputum 17.8%.
Location pleural effusion : right side meet 16/28 (57.1%), left 12/28 (42.9%).
Color pleural fluid: lemon yellow 67.9%; dark gold 25%; pink 7.1%
Protein of pleural fluid: 57.6%

18. Diagnosis and complications
Image of extensive lesions through endoscopic lung surgery: infiltration
Diagnosis of lung endoscopy: TB 20/28 (71.5%); inflammation 5/27 (17.8%); Cancer 3/28 (10.7%). Common complication of pleural endoscopic pain at pleural openings 39.2%; pneumothorax - subcutaneous 10.7%; 3.5% fever.

19. endoscopic images

23. Thank you so much !