Bergmann T, Bölükbas S, Beqiri S, Schirren J
Klinik für Thoraxchirurgie, Dr-Horst-Schmidt-Kliniken, Ludwig-Erhardt-Str. 100, 65199 Wiesbaden.
Chirurg. 2006 Nov;77(11):998-1006. doi: 10.1007/s00104-006-1244-x.
Modern radiologic diagnostics show a variety of pathological changes in the mediastinum, pleura, and lung but no evidence on their histogenesis. Transbronchial and transthoracal fine-needle aspiration biopsy usually cannot yield detailed diagnostic results because of its small size. Sufficient and representative material can be obtained by thoracoscopy. Video-assisted thoracoscopy allows safe and fast diagnosis of diffuse lung diseases, pleural diseases including malignant mesothelioma, indeterminate peripheral lung nodule, and mediastinal masses. This gentle diagnostic method can give invaluable information guiding further management of the thoracic injury. Video-assisted thoracoscopy is a safe and effective guiding tool if performed by experienced thoracic surgeons able to convert to thoracotomy. It is to be noted that interpretation of intraoperative findings plays a decisive role in interdisciplinary diagnostics of intrathoracal diseases.
现代放射诊断显示纵隔、胸膜和肺部有多种病理变化，但无法确定其组织发生情况。经支气管和经胸细针穿刺活检通常因取材量小而无法得出详细的诊断结果。通过胸腔镜检查可获取足够且具有代表性的材料。电视辅助胸腔镜检查能够安全、快速地诊断弥漫性肺部疾病、包括恶性间皮瘤在内的胸膜疾病、周围型肺结节性质不明以及纵隔肿块。这种温和的诊断方法可为指导胸部损伤的进一步治疗提供宝贵信息。如果由有经验且能够转为开胸手术的胸外科医生进行操作，电视辅助胸腔镜检查是一种安全有效的指导工具。需要注意的是，术中发现的解读在胸内疾病的多学科诊断中起着决定性作用。
