The evolving role of thoracoscopy in the diagnosis and treatment of chest disease.

Between April 1, 1988 and April 1, 1993, 88 patients underwent thoracoscopic procedures for diagnosis or treatment or both of diseases which had previously been approached by standard thoracotomy in our practice. Fifty-three (60.2%) were men and 35 (39.8%) women. The median age was 63, range 19 to 88 years. Although the indications for operation generally fell into one of five categories, the ultimate diagnoses established by the procedure spanned a wide array of chest pathology. Morbidity and mortality remained low and length of stay in hospital was favorable in comparison with a subset of patients with malignant pleural disease who underwent thoracotomy for diagnosis. Thoracoscopy, or video-assisted thoracic surgery (VATS), is a procedure which compares favorably with traditional thoracotomy in selected patients and its horizons as a diagnostic and therapeutic tool continue to expand.