Sung S W, Kim J S
Seoul National University Hospital, Korea.
Respirology. 1999 Mar;4(1):19-29. doi: 10.1046/j.1440-1843.1999.00146.x.
Since Jacobaeus performed the first thoracoscopy to explore pleural space and mechanically broke pleural adhesions to facilitate the collapse therapy for pulmonary tuberculosis in 1910, numerous thoracic surgeons have been attempting this technique as a means of accomplishing many intrathoracic procedures previously done through open thoracotomy. As the refinement of video technology has advanced, thoracoscopic surgery has played a very important role in thoracic surgery especially since the early 1990s. Because the advantages of video-assisted thoracoscopic surgery for patients include low post-thoracotomy-related morbidity, cosmetic considerations, low pain, earlier post-operative mobilization, and a shorter operation time in some indications, surgeons have been demonstrating its increasing utility in the diagnosis and treatment of the pleura, lung, mediastinum, great vessels, pericardium, and oesophagus. The most common application of the thoracoscopic approach still remains in the management of pleuropulmonary disease. The indications for the thoracoscopic technique are very broad, but its role in the management of primary lung and oesophageal cancer has yet to be confirmed. Thus, the surgeon who uses the technique in these cancerous diseases should be prudent. In conclusion, these thoracoscopic procedures will play more important roles in the practice of thoracic surgery in the future.
自1910年雅各布厄斯首次进行胸腔镜检查以探查胸膜腔并机械性松解胸膜粘连以促进肺结核的萎陷疗法以来，众多胸外科医生一直试图将该技术作为一种完成许多以前通过开胸手术进行的胸腔内手术的手段。随着视频技术的不断完善，尤其是自20世纪90年代初以来，胸腔镜手术在胸外科中发挥了非常重要的作用。由于电视辅助胸腔镜手术对患者的优势包括较低的开胸术后相关发病率、美观考量、疼痛较轻、术后早期活动以及在某些适应症中手术时间较短，外科医生一直在证明其在胸膜、肺、纵隔、大血管、心包和食管的诊断和治疗中的应用越来越广泛。胸腔镜手术最常见的应用仍然是在胸膜肺部疾病的管理中。胸腔镜技术的适应症非常广泛，但其在原发性肺癌和食管癌管理中的作用尚未得到证实。因此，在这些癌症疾病中使用该技术的外科医生应该谨慎。总之，这些胸腔镜手术在未来的胸外科实践中将发挥更重要的作用。
