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The Annals of Thoracic Surgery, Vol 54, 403-408, Copyright © 1992 by The Society of Thoracic Surgeons
MJ Mack, RJ Aronoff, TE Acuff, MB Douthit, RT Bowman and WH Ryan
Since thoracoscopy was originally described in 1910, the application has
been limited mainly to the diagnosis and treatment of pleural disease.
Recent advancements in endoscopic equipment and refinement of surgical
techniques have expanded the application of this procedure. Using video
thoracoscopic techniques in 70 patients over the past 9 months, we have
been able to perform a variety of procedures previously accomplished by
"open" techniques. These procedures include (1) wedge resections of
pulmonary nodules in 21 patients, using endoscopic mechanical stapling
devices; (2) excision of the pericardium and drainage of the pericardial
space in 6 patients; (3) dorsal thoracic sympathectomy in 6 patients; (4)
apical blebectomy and pleurodesis in 6 patients; (5) lung biopsies for
diagnosis of diffuse lung disease in 5 patients. Additional procedures
performed include biopsy of hilar masses (3), biopsy of esophageal mass,
excision of a mediastinal cyst, and the drainage of a spinal abscess. The
remaining 20 procedures were performed for the diagnosis and treatment of
pleural disease. There was no mortality associated with the procedure and
morbidity was lessened, compared with standard thoracotomy procedures. The
postoperative hospital stay after elective procedures performed in well
patients averaged 3 days and was often as short as 1 day. Our experience
indicates a markedly expanded role for thoracoscopy in the diagnosis and
treatment of thoracic diseases with less postoperative morbidity.
ARTICLES
Present role of thoracoscopy in the diagnosis and treatment of diseases of the chest
Section of Thoracic Surgery, Humana Hospital Medical City Dallas, Texas.
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