Braimbridge M V
Department of Surgery, St Thomas' Hospital, London, United Kingdom.
Ann Thorac Surg. 1993 Sep;56(3):610-4. doi: 10.1016/0003-4975(93)90929-c.
The necessity for thoracoscopy became apparent with the adhesions that limited the success of Forlanini's introduction in 1882 of artificial pneumothorax in the treatment of pulmonary tuberculosis. The first thoracoscopy, using a modified cystoscope, was performed by H. C. Jacobaeus, a professor of medicine, not surgery, in Stockholm, publishing in 1910. Thoracoscopy and division of adhesions (intrapleural pneumonolysis) then spread all over the world, with reports of series of 1,000 or more cases in spite of a significant incidence of complications. Its use declined rapidly after the introduction of streptomycin in 1945, becoming then confined to relatively minor diagnostic procedures except in a few European centers. The advent of video-assisted thoracoscopes and the development of ancillary instruments has allowed a new explosion of thoracoscopic surgery. Surgeons, in whose hands the procedure now rests, should nevertheless be aware of the five unacceptable thoracoscopic disasters--wrong side, kebab lung, "clotted hemothorax," artificial lunchothorax, and aorto-pleuro-cutaneous fistula.
随着粘连的出现，胸腔镜检查的必要性变得明显起来，这些粘连限制了1882年福拉尼尼引入人工气胸治疗肺结核的成功率。1910年，瑞典斯德哥尔摩的医学教授（而非外科教授）H.C.雅各布aeus使用改良的膀胱镜进行了首次胸腔镜检查，并发表了相关报告。随后，胸腔镜检查及粘连松解术（胸膜内肺松解术）在全世界范围内传播开来，尽管并发症发生率很高，但仍有一系列1000例或更多病例的报告。1945年链霉素问世后，其应用迅速减少，随后除了少数欧洲中心外，仅限于相对较小的诊断程序。电视辅助胸腔镜的出现以及辅助器械的发展，使得胸腔镜手术再次蓬勃发展。然而，如今掌握该手术的外科医生应该意识到五种不可接受的胸腔镜手术灾难——手术部位错误、串烤肺、“凝固性血胸”、人工气胸和主动脉-胸膜-皮肤瘘。
