Miller J I
Division of Thoracic Surgery, Emory University School of Medicine, Emory Clinic, Atlanta, Georgia 30308.
Ann Thorac Surg. 1993 Sep;56(3):804-6. doi: 10.1016/0003-4975(93)90986-r.
The past 2 years have witnessed the evolution of video-assisted thoracoscopy in the United States. Performance of the procedure has now moved from the university center to the community hospital. It is clear that thoracoscopy is the modality of choice for both the diagnosis and management of pleural disease (except mesothelioma); the identification of undiagnosed peripheral pulmonary nodules; the removal of simple mediastinal cysts; and the performance of wedge biopsy for interstitial lung disease and simple pericardial procedures. Its role in the management of primary lung cancer and esophageal disease remains to be defined. There are four areas that currently need to be addressed as the present role of therapeutic thoracoscopy evolves: (1) instrumentation, (2) economics, (3) a credentialing process, and (4) its application in certain procedures. All of these are addressed in this presentation.
在过去的两年里，电视辅助胸腔镜技术在美国得到了发展。该手术的开展现已从大学中心转移至社区医院。很明显，胸腔镜检查是胸膜疾病（间皮瘤除外）诊断和治疗、未确诊的周围型肺结节识别、单纯纵隔囊肿切除以及间质性肺病楔形活检和单纯心包手术的首选方式。其在原发性肺癌和食管疾病治疗中的作用仍有待明确。随着治疗性胸腔镜当前作用的不断演变，目前有四个领域需要解决：（1）器械；（2）经济性；（3）认证过程；（4）其在某些手术中的应用。本报告将对所有这些内容进行阐述。
