Avtor/Urednik		Debeljak, Andrej; Kecelj, Peter; Kern, Izidor; Eržen, Janez; Rott, Tomaž
Naslov		Diagnostična torakoskopija pri 201 bolniku od 1985 do 1998
Prevedeni naslov		Diagnostic thoracoscopy done in 201 patients between 1985 and 1998
Tip		članek
Vir		Endoskopska revija
Vol. in št.		Letnik 3, št. 7
Leto izdaje		1998
Obseg		str. 135-9
Jezik		slo
Abstrakt		Background. The aim of our retrospective study was to determine the diagnostic and therapeutic success rate of thoracoscopies performed during the period 1985-1998. Patients and methods. Thoracoscopy was done in 201 patients in whom other less invasive diagnostic procedures had failed. Topical anaesthesia with lidocaine and added fentanyl was used. For histological and cytological studies 11.5 specimens were obrained under visual control. Results. Thoracoscopy provided the definitive diagnosis in 189 patients (94%). Malignant infiltration of the pleura was confirmed in 95 of the 111 patients with neoplastic disease. The accuracy rate of thoracoscopy in patients with neoplasia was 95%. Thoracoscopic preoperative assessment of 26 patients with lung cancer and pleural effusion revealed no pleural neoplasia in 15 patients; later 9 or these (35%) were sucessfully treated by surgery. Talc pleurodesis was done in 50 patients: in 41 with malignant pleural effusion, 3 with benign effusion and 6 with recurrent pneumothorax. Immediate success was achieved in 41 cases (82%). Thoracoscopy was most frequently complicated by subcutaneous emphysema (23 cases), and pain following talc instillation (16 cases). The most serious complications were bronchopleural fistula in 12 and trapped lung in 3 patients. Conclusions. Diagnostic thoracoscopy improves the accuracy of diagnosis of pleural diseases, and enables us to perform a successful pleurodesis.
Izvleček		Izhodišča. Cilj retrospektivne študije je bil ugotoviti diagnostične in terapevtske uspehe diagnostičnih torakoskopij, narejenih od leta 1985 do 1998. Bolniki in metode. Torakoskopirali smo bolnike, pri katerih nismo uspeli postaviti diagnoze z manj invazivnimi preiskavami, skupaj 201 bolnika. Uporabljali smo lahko anestezijo z lidokainom in dodajanjem fentanila. Pod kontrolo očesa smo odvzeli po 11,5 bioptičnih koščkov z ahistološke in citološke preiskave. Rezultati. Pri 189 bolnikih (94%) je torakoskopija razjasnila diagnozo. Med 111 bolniki z malignimi boleznimi smo pri 95 (86%) potrdili maligno infiltracijo plevre. Pri bolnikih z malignimi boleznimi je bila natančnost torakoskopske diagnoze 95-odstotna. Pri 26 bolnikih s pljučnim rakom in plevralnim izlivom torakoskopsko pred operacijo 15-krat nismo našli karcinoze plevre. Kasneje je bilo 9 bolnikov (35%) uspešno operiranih. Plevrodezo s smukcem smo napravili pri 50 bolnikih: pri 41 z malignimi, pri 3 z benignimi plevralnimi izlivi in pri 6 ponavljajočim se pnevmotoraksom. Takojšen uspeh smo dosegli pri 41 bolnikih (82%). Najpogostejši zapleti so bili podkozni emfizem pri 23 bolnikih in bolečina po vpihanju smukca pri 16 bolnikih. Najtežji zapleti so bili bronhoplevralna fistula pri 12 in "ujeta pljuča" pri 3 bolnikih. Sklep. Diagnostična torakoskopija izboljša diagnozo plevralnih bolezni in omogoči uspešno plevrodezo.
Deskriptorji		PLEURAL EFFUSION, MALIGNANT THORACOSCOPY LUNG NEOPLASMS PLEURODESIS EMPHYSEMA PNEUMOTHORAX BRONCHIAL FISTULA