{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T04:45:42Z","timestamp":1782449142388,"version":"3.54.5"},"reference-count":16,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Noncommunicable Chronic DiseasesNational Science and Technology Major Project","award":["2024ZD0522604\/2024ZD0522600 to S Li"],"award-info":[{"award-number":["2024ZD0522604\/2024ZD0522600 to S Li"]}]},{"name":"Noncommunicable Chronic DiseasesNational Science and Technology Major Project","award":["2024ZD0529505\/2024ZD0529500 to D Liu"],"award-info":[{"award-number":["2024ZD0529505\/2024ZD0529500 to D Liu"]}]},{"name":"1\u22193\u22195Project of State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University","award":["RHM24206"],"award-info":[{"award-number":["RHM24206"]}]},{"DOI":"10.13039\/501100019491","name":"National Natural Science Foundation of China - State Grid Corporation Joint Fund for Smart Grid","doi-asserted-by":"publisher","award":["82570148"],"award-info":[{"award-number":["82570148"]}],"id":[{"id":"10.13039\/501100019491","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Respir Dis"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Medical thoracoscopy (MT) is primarily employed to obtain histopathological evidence via parietal pleural biopsy. However, parietal pleural lesions are not uniformly accessible, and evidence on visceral pleural biopsy remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This study aimed to investigate the diagnostic sensitivity and safety of visceral pleural biopsy performed under semi-rigid MT in patients with undiagnosed exudative pleural effusions (EPEs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Single-center retrospective observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on 459 patients with undiagnosed EPEs who underwent pleural biopsy via MT. Among the 324 patients who met the inclusion and exclusion criteria, 38 who underwent visceral pleural biopsy and 74 who underwent parietal pleural biopsy were included in the final analysis after propensity score matching. The diagnostic sensitivity and safety were determined for both groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The diagnostic sensitivity was 78.9% in the visceral pleural group (85.7% for malignancy and 55.6% for tuberculosis) and 91.9% in the parietal pleural group (92.6% for malignancy and 89.5% for tuberculosis). Subgroup analysis based on macroscopic patterns suggested that the difference in diagnostic sensitivity was mainly driven by cases of tuberculous pleural effusion presenting as diffuse pleural thickening under MT, whereas comparable sensitivities were observed between the two groups in malignant pleural effusion and nodular-type tuberculous pleural effusion. The median time to chest tube removal was 2\u2009days in both the visceral pleural group and the parietal pleural group. No statistically significant differences were observed between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Medical thoracoscopic visceral pleural biopsy is safe and demonstrates comparable diagnostic sensitivity to parietal pleural biopsy for malignancies and tuberculosis presenting as nodular lesions under MT in patients with undiagnosed EPEs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17534666261455300","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T17:46:57Z","timestamp":1782236817000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic sensitivity and safety of visceral pleural biopsy under semi-rigid medical thoracoscopy in patients with undiagnosed exudative pleural effusions: a retrospective study"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5773-1039","authenticated-orcid":false,"given":"Rui","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, the People\u2019s Hospital of Pengzhou, Chengdu, Sichuan Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fen","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0985-0311","authenticated-orcid":false,"given":"Weimin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, 37 Guoxue Lane, Wuhou District, Chengdu, Sichuan 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4824-7485","authenticated-orcid":false,"given":"Kaige","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, 37 Guoxue Lane, Wuhou District, Chengdu, Sichuan 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1403503"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13665-024-00366-9"},{"key":"e_1_3_4_4_2","first-page":"1041","article-title":"Pleural controversies: image guided biopsy vs. Thoracoscopy for undiagnosed pleural effusions?","volume":"7","author":"Dixon G","year":"2015","unstructured":"Dixon G, de Fonseka D, Maskell N. Pleural controversies: image guided biopsy vs. Thoracoscopy for undiagnosed pleural effusions? J Thorac Dis 2015; 7: 1041\u20131051.","journal-title":"J Thorac Dis"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.13-1187"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/MCP.0000000000001039"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/thorax-2023-220304"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcdt.2015.01.004"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-3003.1999.14c17.x"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-025-03229-2"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2010.137018"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/2373997516632752"},{"key":"e_1_3_4_14_2","first-page":"112","article-title":"Thoracoscopy in diffuse lung diseases","volume":"43","author":"Schaberg T","year":"1989","unstructured":"Schaberg T, Suttmann-Bayerl A, Loddenkemper R. Thoracoscopy in diffuse lung diseases. 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