Casadio C, Giobbe R, Cianci R, Molinatti M, Oliaro A, Maggi G
Department of Thoracic Surgery, University of Turin, Italy.
J Cardiovasc Surg (Torino). 1994 Oct;35(5):445-8.
Video-assisted thoracic surgical procedures continue to be performed with increased frequency; the role of this new technique in the treatment of pulmonary malignancies or metastatic mediastinal adenopathies is not yet defined. Out of a series of 100 consecutive video-assisted thoracic operations, 22 patients resulted affected by a malignancy in the lung or in the subcarinal lymphnodes: six patients had a primary lung cancer and were operated with a video-assisted small thoracotomy of 5 cm (three lobectomy and three segmentectomy) because of a very poor respiratory reserve. Nine patients received a video-assisted wedge resection of a nodule resulted at the frozen section a metastasis of a carcinoma: a small thoracotomy of 8 cm was made and a hand entered the thoracic cage to obtain a careful palpation of the entire lung; five patients had enlarged lymphnodes only in posterior and inferior mediastinum, inaccessible by cervical mediastinoscopy or anterior mediastinotomy: thoracoscopic exploration obtained a useful mediastinal nodal sampling for these adenopathies. In selected cases video-assisted thoracic surgery can be used for resection or assessment of thoracic malignancies.
电视辅助胸腔手术的实施频率持续增加；这项新技术在治疗肺部恶性肿瘤或纵隔转移性淋巴结肿大方面的作用尚未明确。在连续的100例电视辅助胸腔手术中，有22例患者患有肺部或隆突下淋巴结恶性肿瘤：6例患者患有原发性肺癌，由于呼吸储备非常差，接受了5厘米的电视辅助小切口开胸手术（3例肺叶切除术和3例肺段切除术）。9例患者接受了电视辅助结节楔形切除术，术中冰冻切片显示为癌转移：做了8厘米的小切口开胸手术，术者将手伸入胸腔仔细触诊整个肺部；5例患者仅后纵隔和下纵隔淋巴结肿大，无法通过颈部纵隔镜检查或前纵隔切开术触及：胸腔镜探查为这些肿大淋巴结获取了有用的纵隔淋巴结样本。在特定病例中，电视辅助胸腔手术可用于切除或评估胸部恶性肿瘤。
