Elfeldt R, Schröder D, Beske C
Chirurgischen Universitätsklinik, Abteilung Allgemeine Chirurgie Kiel.
Zentralbl Chir. 1989;114(5):281-5.
Thoracoscopy is an invasive form of endoscopy which, however, can be performed with the patient in local anaesthesia. Hence, when it comes to patients, for example, in somewhat advanced age and thus with the surgical risk clearly increased, it can be used as the smallest possible intervention to clear up causes of effusions of unknown origin and can thus be helpful in avoiding an otherwise necessary operation with all associated possible complications. It can be also used in many cases to clear up new growths in the thoracic wall of the mediastinum or diaphragm or, just as well, diffuse or locally delimited pulmonary diseases. When it comes to spontaneous pneumothorax, thoracoscopy should be restricted to selected cases because of relatively high rates of recurrence. Surgical indications in such cases should be handled with more generosity. Thoracoscopy is not indicated in cases of bullae of large size or radiological detectability. Here, thoracotomy should be the option.
胸腔镜检查是一种侵入性内镜检查形式，不过可以在患者局部麻醉的情况下进行。因此，例如对于年龄稍大、手术风险明显增加的患者，它可用作尽可能小的干预措施，以查明不明原因胸腔积液的病因，从而有助于避免原本必要的手术及其所有相关的可能并发症。在许多情况下，它还可用于查明纵隔或膈肌胸壁的新生物，或者同样用于查明弥漫性或局限性肺部疾病。对于自发性气胸，由于复发率相对较高，胸腔镜检查应限于特定病例。在这种情况下，手术指征的把握应更加宽松。对于大疱或影像学可检测到的病例，不建议进行胸腔镜检查。在此类情况下，应选择开胸手术。
