[Thoracoscopic surgery for diagnosis and treatment of pleural and mediastinal disease].

We studied the usefulness of thoracoscopic surgery in the diagnosis and treatment of pleural and mediastinal lesions. 1. Thoracoscopic surgery was the best method for biopsy of pleural lesions or effusion-retaining disease. Thoracoscopic surgery allowed extensive intrathoracic inspection and collection of relatively large tissue samples, even though it is less invasive than thoracotomy. 2. Thoracoscopic biopsy was useful in the diagnosis of tumorous lesions of the anterior, middle, and posterior parts of the mediastinum. 3. Thoracoscopic surgery is indicated for treatment of the following five pleural diseases: (1) benign pleural tumors; (2) localized mesothelioma; (3) persistent pleural effusions; (4) pyothorax; and (5) chylothorax. 4. Benign mediastinal tumor is a clear indication for thoracoscopic surgery, but utmost caution must be exercised in applying this technique to the treatment of malignant tumors. 5. Thoracoscopic extended thymectomy with a collar incision of the neck is a useful and relatively non-invasive technique for the treatment of myasthenia gravis without thymoma.