Ladjimi S, Djemel A, Ben Youssef R, Ben Ayed F, Jaziri M, Belhassen S, Kammoun M, Zegaya M, Mourali N
Rev Mal Respir. 1985;2(6):355-9.
From May 1983 to June 1985 the authors performed a thoracoscopy as a diagnostic and therapeutic objective in 83 patients with chronic recurrent pleurisy; amongst these patients, 69 had know intra or extra thoracic cancer and the other 14 presented with an isolated pleurisy. Eight other patients had pleural carcinomatosis proven by needle biopsy and had pleural talc introduced by thoracoscopy. The examination was performed under local anaesthesia with neuroleptanalgesia; a rigid 7 mm diameter thoracoscope was used; the biopsies were performed uniquely on the parietal pleura using tropical forceps. The outcome was uncomplicated with no deaths nor any serious complications due to the method. The sensitivity of the pleural biopsy was 91.5% or 76 positive biopsies out of 83. 73 biopsies were metastatic and 3 were tuberculous pleurisies. The macroscopic appearance was strongly suggestive of malignancy in 78 patients and appeared inflammatory in 13, of whom 9 cases were positive on biopsy. The authors performed a pleural talcage in every case; a lasting pleural adhesion was obtained in 66 patients but regrettably there were 14 failures, the effusion recurring after removal of the drain. The authors stress the reduced number of incidents of pleural effusion, which confirms the good tolerance of pleural endoscopy.
1983年5月至1985年6月，作者对83例慢性复发性胸膜炎患者进行了胸腔镜检查，以达到诊断和治疗目的；在这些患者中，69例患有已知的胸内或胸外癌症，另外14例表现为单纯性胸膜炎。另有8例经针吸活检证实为胸膜癌转移的患者，通过胸腔镜进行了胸膜滑石粉植入术。检查在局部麻醉和神经安定镇痛下进行；使用直径7mm的硬质胸腔镜；活检仅使用热带钳在壁层胸膜上进行。结果无并发症，无死亡病例，该方法也未引起任何严重并发症。胸膜活检的敏感性为91.5%，即83例中有76例活检阳性。73例活检为转移性，3例为结核性胸膜炎。78例患者的宏观表现强烈提示为恶性肿瘤，13例表现为炎症，其中9例活检呈阳性。作者对每例患者均进行了胸膜滑石粉植入术；66例患者获得了持久的胸膜粘连，但遗憾的是有14例失败，引流管拔除后胸腔积液复发。作者强调胸腔积液的发生率降低，这证实了胸腔镜检查具有良好的耐受性。
