Kohno T, Ohtsuka T, Nakajima J, Yagyu K, Akira F
Department of Cardiothoracic Surgery, Faculty of Medicine, University of Tokyo, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1994 Dec;32 Suppl:169-73.
Recently developed thoracoscopic surgical equipment and related instruments have enabled us to perform two groups of advanced thoracoscopic surgical procedures. Group 1: procedures formerly performed by open thoracotomy, and group 2: procedures performed by thoracoscopic surgery only. Group 1 includes bullectomy for spontaneous pneumothorax, wedge resection for lung nodules, resection of benign tumors of the mediastium or chest wall, lung lobectomy, and resection of giant bullae. Because thoracoscopic surgery is minimally invasive, intrathoracic surgical procedures should be performed by thoracoscopic surgery if the results are the same. Group 2 consists of surgery in patients with poor pulmonary reserve and laser ablation of the bullous lung in advanced emphysema. Until recently, surgical intervention was not an option in the patients in groups 2 because of the invasiveness of open thoracotomy. Thoracoscopic surgery allows resection of tumors in early stage lung cancer in patients with poor pulmonary reserve. Severely emphysematous lungs can be ablated with a laser and shrunk, to normalize pulmonary compliance, residual volume and total lung capacity, and thus relieve symptoms.
