• Jonathan Puchalski.
• Department of Medicine, Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, Connecticut.
• Semin Respir Crit Care Med. 2019 Jun 1; 40 (3): 410-416.

AbstractPleural effusions are common and associated with high morbidity and mortality. Whereas thoracentesis can assist in achieving a diagnosis or therapy, advances in education and in the technique may prevent morbidity associated with the procedure. Medical thoracoscopy is often useful for undiagnosed effusions, as well as for therapeutic purposes. There is much enthusiasm about techniques for biopsies that extend beyond forceps. These include biopsies using a diathermic knife as well as cryoprobes. Similarly, adhesiolysis or other techniques to improve therapy in multiloculated effusions using medical thoracoscopy are contested. This review attempts to synthesize recent advances and controversies in thoracentesis and medical thoracoscopy as clinicians head into the next decade of treatment.Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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