Rieger R, Schrenk P, Woisetschläger R, Wayand W
2nd Department of Surgery and the Ludwig Boltzmann Institute for Laparoscopic Surgery, General Hospital of Linz, Krakenhausstrasse 9, A-4020 Linz, Austria.
Surg Endosc. 1996 Jul;10(7):715-7. doi: 10.1007/BF00193041.
The indications for video-assisted thoracoscopy have steadily expanded during recent years and include now the management of various mediastinal disorders.
Until now we have used videothoracoscopy for the diagnosis or treatment of mediastinal mass lesions in 28 patients. The indication for the procedure was bilateral or unilateral mediastinal adenopathy in 16, a suspected malignant anterior mediastinal mass lesion in six, and a presumable benign tumor of the posterior or anterior mediastinum in six patients.
Video-assisted thoracoscopy provided an accurate tissue diagnosis in all patients with adenopathy and in all but one patient with a malignant mass lesion of the anterior mediastinum. It further allowed complete excision of all benign tumors of the anterior or posterior mediastinum. There were no intra- or postoperative complications, but conversion to open thoracotomy was necessary in one patient.
Video-assisted thoracoscopy is a valuable adjunct to traditional surgical techniques for the diagnosis of malignant mediastinal disease and may overcome some of the limitations of mediastinoscopy and mediastinotomy. In the future, it may become the procedure of choice for the resection of small benign tumors of the anterior or posterior mediastinum.
近年来，电视辅助胸腔镜检查的适应证不断扩大，目前包括各种纵隔疾病的处理。
到目前为止，我们已使用电视胸腔镜对28例纵隔肿块病变进行诊断或治疗。该手术的适应证为双侧或单侧纵隔淋巴结肿大16例，可疑恶性前纵隔肿块病变6例，以及6例后纵隔或前纵隔可能的良性肿瘤。
电视辅助胸腔镜检查为所有淋巴结肿大患者以及除1例前纵隔恶性肿块病变患者外的所有患者提供了准确的组织诊断。它还能完全切除所有前纵隔或后纵隔的良性肿瘤。无术中或术后并发症，但有1例患者需要转为开胸手术。
电视辅助胸腔镜检查是传统手术技术诊断恶性纵隔疾病的有价值辅助手段，可能克服纵隔镜检查和纵隔切开术的一些局限性。未来，它可能成为切除前纵隔或后纵隔小良性肿瘤的首选手术。
