Kaiser L R, Shrager J B
Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, USA.
AJR Am J Roentgenol. 1995 Nov;165(5):1111-7. doi: 10.2214/ajr.165.5.7572485.
Surgical thoracoscopy (or pleuroscopy) has historically been underused in the diagnosis and therapy of diseases of the chest. The rapid developments in laparoscopy in recent years caused thoracic surgeons to reconsider the use of endoscopic techniques in surgery of the chest. Advances in video camera technology and the use of digital processing technology so expanded the potential of thoracoscopy that an entirely new set of procedures, called video-assisted thoracic surgery, has emerged. This article reviews situations in which video-assisted procedures have proven useful, the techniques by which these procedures are performed, and the rationale behind using the video-assisted in lieu of the open approach. Video-assisted surgery often allows one to accomplish the same goal as the comparable open procedure but with less morbidity and a shorter hospital stay. With continued development of instrumentation, increasingly complex procedures continue to be accomplished. It is important for radiologists to be aware of these new developments in minimally invasive surgery, as the techniques have major implications for the practice of chest medicine and surgery as a whole. The evolution of the management of the solitary pulmonary nodule is but one example of the way video-assisted thoracic surgery has called into question the traditional approach to diseases of the chest.
历史上，外科胸腔镜检查（或胸膜镜检查）在胸部疾病的诊断和治疗中未得到充分利用。近年来腹腔镜技术的快速发展促使胸外科医生重新考虑在内镜技术在胸部手术中的应用。摄像机技术的进步和数字处理技术的应用极大地扩展了胸腔镜检查的潜力，从而出现了一套全新的手术方法，即电视辅助胸腔手术。本文回顾了电视辅助手术已被证明有用的情况、实施这些手术的技术以及使用电视辅助手术代替开放手术方法的基本原理。电视辅助手术通常能实现与类似开放手术相同的目标，但发病率更低，住院时间更短。随着器械的不断发展，越来越复杂的手术也能得以完成。放射科医生了解这些微创手术的新发展非常重要，因为这些技术对整个胸部医学和外科的实践有着重大影响。孤立性肺结节管理方法的演变只是电视辅助胸腔手术对传统胸部疾病治疗方法提出质疑的一个例子。
