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Thoracoscopy: medical versus surgical—in the management of pleural diseases

机译:胸腔镜:内科与外科—胸膜疾病的治疗

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摘要

Diseases of the pleura continue to affect a large population of patients worldwide and in the United States. Pleural fluid analysis and accompanying imaging of the pleura including chest X-rays, chest computed tomography (CT) scan and chest ultrasonography are among the first steps in the management of pleural effusions. When further diagnostic or therapeutic work up is necessary, open thoracotomy and thoracoscopy come to mind. However, given the significant morbidity and mortality associated with open thoracotomy, and the advances in medicine and medical instruments, thoracoscopy has now become a routine procedure in the management of the disease of the chest including pleura. Debates about surgical vs. medical thoracoscopy (MT) are ongoing. In the following pages we review the literature and discuss the similarities and differences between the two procedures, as well as their indications, contraindications, complications and efficacy in the management of pleural diseases.
机译:胸膜疾病继续影响着全世界和美国的大量患者。胸膜积液分析的第一步包括胸腔积液分析和伴随的胸膜影像检查,包括胸部X光,胸部计算机断层扫描(CT)扫描和胸部超声检查。当需要进一步的诊断或治疗检查时,可以想到开胸手术和胸腔镜检查。然而,考虑到与开胸手术有关的高发病率和高死亡率,以及医学和医疗器械的进步,胸腔镜检查现已成为处理包括胸膜腔在内的胸部疾病的常规方法。关于外科胸腔镜与医学胸腔镜(MT)的争论仍在进行中。在接下来的几页中,我们将回顾文献并讨论这两种方法之间的异同,以及它们在胸膜疾病治疗中的适应症,禁忌症,并发症和疗效。

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