胸腔镜检查及术前定位程序在肺部疾病诊断和管理中的作用。

Role of thoracoscopy and preoperative localization procedures in the diagnosis and management of pulmonary pathology.

作者信息

Shah R M, Spirn P W, Salazar A M, Steiner R M, Cohn H E, Wechsler R J

机构信息

Department of Radiology, Jefferson Medical College, Philadelphia, PA, USA.

出版信息

Semin Ultrasound CT MR. 1995 Oct;16(5):371-8. doi: 10.1016/0887-2171(95)90026-8.

DOI:10.1016/0887-2171(95)90026-8

PMID:8527170

Abstract

Video-assisted thoracic surgery is an important component of modern thoracic surgery, providing a safe, less invasive alternative to open thoracotomy in the evaluation of pleural, mediastinal, and parenchymal pathology. Advancements in endoscopic techniques and video-optics have permitted greater visualization of the thoracic cavity and allowed limited pulmonary resections with significantly reduced postoperative morbidity. Thoracoscopy is indicated for diagnosis of intrathoracic pathology when usual methods of diagnosis, including fine-needle aspiration and transbronchial biopsy, are inconclusive. The diagnostic accuracy of video-assisted thoracic surgery approaches 100%. Increasingly, the indications for thoracoscopy include therapeutic resections of pulmonary nodules in cases of limited lung metastases and bronchogenic carcinoma when pulmonary function is poor. Successful diagnostic and therapeutic resection by thoracoscopy requires intraoperative localization of the lesion within the collapsed lung. The indications and methods of thoracoscopic surgery and preoperative localization are discussed.

摘要

电视辅助胸腔镜手术是现代胸外科的重要组成部分，在评估胸膜、纵隔和实质病变时，它为开胸手术提供了一种安全、侵入性较小的替代方法。内镜技术和视频光学的进步使胸腔的可视化程度更高，并允许进行有限的肺切除术，术后发病率显著降低。当常规诊断方法（包括细针穿刺和经支气管活检）无法得出结论时，胸腔镜检查可用于诊断胸内病变。电视辅助胸腔镜手术的诊断准确率接近100%。越来越多的情况是，当肺功能较差时，胸腔镜检查的适应症包括对局限性肺转移和支气管源性癌病例中的肺结节进行治疗性切除。通过胸腔镜成功进行诊断和治疗性切除需要在萎陷肺内对病变进行术中定位。本文讨论了胸腔镜手术的适应症、方法以及术前定位。