Krasna M J, McLaughlin J S
Department of General Thoracic Surgery, University of Maryland School of Medicine, Baltimore.
Surg Laparosc Endosc. 1994 Jun;4(3):182-8.
Thoracoscopy has become an important tool in the diagnosis and management of intrathoracic disease. Between April 1991 and October 1992, 93 patients underwent thoracoscopy. Lung resection was performed on nineteen patients for diagnoses of interstitial lung disease and on seven patients for pulmonary nodules. Eleven patients underwent therapeutic lung resection for management of pneumothorax or air leaks. Sixteen patients underwent thoracoscopy for pleural disease. This was to diagnose mesothelioma (2), to lyse benign adhesions (2), to drain empyema (2), and to evacuate loculated pleural effusion (10) thoracoscopically. Nine patients underwent thoracoscopic staging for lung cancer. Thirteen patients underwent thoracoscopic staging for esophageal cancer as part of a prospective trial. Other indications for thoracoscopy included pericardiectomy (6), sympathectomy (2), and resection of mediastinal mass (4). Thoracoscopy is an excellent option for patients at high risk from standard thoracotomy and may allow procedures to be performed which would prevent the need for open thoracotomy, resulting in shorter hospital stay and less postoperative pain.
胸腔镜检查已成为诊断和治疗胸内疾病的重要工具。1991年4月至1992年10月期间，93例患者接受了胸腔镜检查。19例患者因间质性肺疾病诊断而接受肺切除术，7例患者因肺结节接受肺切除术。11例患者因气胸或漏气的治疗而接受治疗性肺切除术。16例患者因胸膜疾病接受胸腔镜检查。其中包括诊断间皮瘤（2例）、松解良性粘连（2例）、引流脓胸（2例）以及通过胸腔镜排出包裹性胸腔积液（10例）。9例患者接受了肺癌的胸腔镜分期。13例患者作为前瞻性试验的一部分接受了食管癌的胸腔镜分期。胸腔镜检查的其他适应证包括心包切除术（6例）、交感神经切除术（2例）以及纵隔肿物切除术（4例）。对于因标准开胸手术风险高的患者，胸腔镜检查是一个极佳的选择，并且可能使一些手术得以实施，从而避免进行开胸手术，缩短住院时间并减轻术后疼痛。
