الفهرس 
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Abstract
Unlike thoracocentesis and closed pleural biopsy (CPB), medical thoracoscopy permits biopsy with direct visualization. Medical thoracoscopy appears to be efficient and relatively safe in the management of pleural disease.Minithoracoscopy is safe and effective for routine diagnostic applications. The most relevant indications of minithoracoscopy in the medical field are small effusions, pleural effusions in patients with narrow intercostal spaces and suspected tuberculous pleurisy in areas of low incidence of tuberculosis.The current study was conducted to compare between minithoracoscope and medical thoracoscope in patients with undiagnosed exudative pleural effusion as regard the diagnostic yield, safety, complications, and duration of hospital stay. This study was an Interventional Randomized study conducted in chest medicine department, Mansoura University Hospitals, Faculty of Medicine, Mansoura University in the period from November 2017 to November 2018 after getting the approval from the Institutional Research Board of Faculty of Medicine at Mansoura University. Patients were divided randomly into two groups. The first group included 30 patients with undiagnosed exudative pleural effusion whose minithoracoscope were done according to standard protocol, while the second group included 30 patients with undiagnosed exudative pleural effusion whose standard thoracoscope were done according to standard protocol.Results:The percentage of adhesion, nodule, plaques and anthracotic patches were comparable to some extent among both groups. All cases in minthoracoscope group revealed mild pain while 60% only in medical thoracoscope group revealed mild pain and the remaining 40% of cases reveled moderate and severe pain with highly statistically significant differences among both group (P ˂ 0.001).The majority of minithoracoscope group revealed surgical emphysema grade zero while the majority of medical thracoscope group revealed surgical emphysema grade (I, II and III) with statistically significant differences among both group (P=0.041). Incomplete lung expansion after 5 days revealed to be rare in medical thoracoscope group while slightly higher in minithoracoscope gThe percentages of persistent air leak, bleeding and tube obstruction were comparable among both group and revealed no statistically significance. In conclusion, Minithoracoscopy can be considered as alternative technique to the standard method for medical thoracoscopy but it is more time consuming ; it can be applied for small effusions that are inaccessible to standard equipment and is well tolerated by patients with minimal pain and early hospital discharge.