Celik M, Halezeroglu S, Senol C, Keles M, Yalcin Z, Urek S, Kiral H, Arman B
Department of Chest Surgery, Heybeliada Chest Disease and Chest Surgery Center, Istanbul, Turkey.
Eur J Cardiothorac Surg. 1998 Aug;14(2):113-6. doi: 10.1016/s1010-7940(98)00167-5.
Until recently, thoracoscopy had been used primarily for diagnostic purposes for more than 80 years in thoracic diseases. In this report we reviewed our video-assisted thoracoscopic surgery experience with 341 cases focusing on indications, operative procedures, complications or failure rates.
Over the last 3 years, we performed 459 video-assisted thoracoscopic procedures. There were 206 male and 135 female patients.
The indications were diagnostic in 171 cases, and therapeutic in 170 cases. There were no operative mortality. Non-fatal complications were seen in 15 cases (4.4%). The mean postoperative stay was 5 days. The specific procedures performed were operations on the pleura (237 cases), lung (158 cases), mediastinum (56 cases) and pericardium (four cases). Conversion to thoracotomy was needed in 43 cases (12.6%). Definitive diagnosis was obtained in 100% of patients with pulmonary nodule/mass or diffuse lung disease, and 95.2% of patients with undiagnosed pleural effusions. The success rate of thoracoscopic approach in non-tuberculous thoracic empyema was 87.3%.
Video-assisted thoracoscopic surgery is an ideal procedure in the following situations: (1) undiagnosed pleural effusion, (2) recurrent pneumothorax or bullous lung disease, (3) stage II thoracic empyema, (4) lung cancer staging, (5) peripheral pulmonary nodule, and (6) wedge biopsy for diffuse lung disease.
直到最近，胸腔镜在胸部疾病中主要用于诊断目的已有80多年。在本报告中，我们回顾了341例电视辅助胸腔镜手术的经验，重点关注适应证、手术操作、并发症或失败率。
在过去3年中，我们进行了459例电视辅助胸腔镜手术。其中男性患者206例，女性患者135例。
适应证为诊断性的有171例，治疗性的有170例。无手术死亡病例。15例（4.4%）出现非致命性并发症。术后平均住院时间为5天。具体实施的手术包括胸膜手术（237例）、肺部手术（158例）、纵隔手术（56例）和心包手术（4例）。43例（12.6%）需要转为开胸手术。100%的肺结节/肿块或弥漫性肺疾病患者以及95.2%的不明原因胸腔积液患者获得了明确诊断。胸腔镜治疗非结核性胸腔积脓的成功率为87.3%。
电视辅助胸腔镜手术在以下情况是一种理想的手术：（1）不明原因胸腔积液；（2）复发性气胸或肺大疱疾病；（3）Ⅱ期胸腔积脓；（4）肺癌分期；（5）周围型肺结节；（6）弥漫性肺疾病的楔形活检。
