Boutin C, Farisse P, Viallat J R, Cargnino P, Choux R
Rev Fr Mal Respir. 1979 Dec;7(7):680-6.
Thoracoscopy with a single opening was carried out under general anesthesia with a cold light thoracoscope of 7 mm in diameter. Biopsies were taken under visual control for optical and electron microscopic examination. In a series of 40 mesotheliomas, 30 patients with pleural effusion underwent 36 thoracoscopies. In 29 patients the macroscopic lesions were compatible with the diagnosis of mesothelioma. The most specific aspects consisted in white-yellowish nodules, almost translucent, arising from the parietal pleura (9 patients). Another typical pattern, a dense pleural thickening, was found in 10 patients. In the remaining patients, the lesions observed were less specific. The biopsy was positive in 35/36 thoracoscopies (97%). A talc poudrage was carried out in 10 patients: their mean survival was 458 days. In ten matched mesothelioma patients who underwent pleurectomy the mean survival was only 395 days. In 12 patients at an early stage, the visceral pleura was not involved by the tumor: their mean survival was 636 days. In 11 patients both parietal and visceral pleura were involved by the tumor: their mean survival was 138 days: (p less than 0,001). It is concluded that in mesothelioma pleural effusions, thoracoscopy is a safe and efficient procedure in order to reach a precise diagnosis, prognosis and efficient palliative treatment of the effusion.
在全身麻醉下，使用直径7毫米的冷光胸腔镜进行单孔胸腔镜检查。在直视下进行活检，以用于光学和电子显微镜检查。在一系列40例间皮瘤患者中，30例有胸腔积液的患者接受了36次胸腔镜检查。29例患者的宏观病变与间皮瘤诊断相符。最具特征性的表现为白色至淡黄色结节，几乎半透明，起源于壁层胸膜（9例患者）。10例患者发现另一种典型表现，即致密的胸膜增厚。其余患者观察到的病变特异性较低。36次胸腔镜检查中有35次活检呈阳性（97%）。10例患者进行了滑石粉胸膜固定术：他们的平均生存期为458天。10例接受胸膜切除术的配对间皮瘤患者的平均生存期仅为395天。12例早期患者，肿瘤未累及脏层胸膜：他们的平均生存期为636天。11例患者壁层和脏层胸膜均受累：他们的平均生存期为138天：（p<0.001）。结论是，对于间皮瘤胸腔积液，胸腔镜检查是一种安全有效的方法，可用于准确诊断、判断预后以及对积液进行有效的姑息治疗。
