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Objective To investigate the effect of thoracoscopy under local anesthesia in diagnosis and treatment of tuberculous encysted pleural effusion. Method 143 patients with tuberculous encysted pleural effusion were divided into two groups according to historical comparison method: thoracoscopic group (n = 64) and control group (n =79) . The corresponding diagnosis and treatment were retrospectively analyzed, and the pathological diagnosis rate, changes in lung function, chest tightness and shortness of breath disappear, complications after treatment were compared between the two groups. Results The pathological diagnosis rate, vital capacity of lung function expected percentages ( FVC% ) and forced expiratory volume in 1 second take up of the expected (FEV1%) values in the thoracoscopic group were higher than the control group, but chest tightness, shortness of breath disappear time were lower than the control group, the differences were significant (P < 0.05) . 1 case of severe complications occurred in the thoracoscopic group. Conclusion The effect of thoracoscopy under local anesthesia is good in diagnosis and treatment of tuberculous encysted pleural effusion, it is simple and has low incidence of severe complications, so is worth clinical promotion. [ABSTRACT FROM AUTHOR]