[Utility of thoracoscopy for diagnosis of pulmonary diseases in clinical pulmonary medicine].

Thoracoscopy is useful for diagnosis of a number of lung diseases. We report our recent experience with thoracoscopy in 86 patients and with video-assisted thoracic surgery in 105 patients. In 70 patients with pleural effusion, thoracoscopic pleural biopsy was done under local anesthesia. All malignant pleural effusions that were not diagnosed by cytologic examination of pleural effusion fluid were diagnosed by thoracoscopy. Especially in malignant mesothelioma, thoracoscopy yielded correct diagnoses. No complication was observed. In 45 patients with a solitary pulmonary nodular lesion and in 27 patients with diffuse interstitial lung diseases, thoracoscopic lung biopsy was done with an "endo-stapler", under general anesthesia. The diagnostic accuracy of this procedure was excellent. Plasma neutrophil elastase and IL-6 levels were measured after surgery as markers of the invasiveness of the procedure. The results indicated that thoracoscopic lung biopsy is relatively safe and non-invasive. Thoracoscopy has become an indispensable tool in the daily practice of pulmonology.