Author/Editor		Debeljak, Andrej; Drinovec, Igor; Eržen, Janez; Rott, Tomaž; Mermolja, Milivoj
Title		Diagnostična torakoskopija
Translated title		Diagnostic thoracoscopy
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 65, št. Suppl 2
Publication year		1996
Volume		str. II-9-12
Language		slo
Abstract		Background. Diagnostic thoracoscopy helps in establishing diagnosis for patients with pleural diseases when more noninvasive procedures have failed. Whe article reviews our experience with this method. Methods. In a retrospective analysis the success of 138 thoracoscopies from 1985 to 1995 was evaluated. Procedures were performed in local anaesthesia with lidocain. pneumothorax was applied and controlled by roentgenogram prior to thoracoscopy. Through a Storz thoracoscope under visual control, 2 to 25 samples of pleura were obtained for histological and cytological examination. The patients were on drainage for 2.9 days after the procedure. Results. Thoracoscopy clarified the nature of the disease in 127 patients. In 70 cancer patients the sensitivity was 93 %, acuracy 94 % and specificity 100 %. Out 21 patients with lung cancer and pleural effusion, established by thoracoscopy, eiht underwent lobectomy or pulmonectomy. Pleurodesis with talcum was achieved in 13 out of 16 patients with pleural effusion in 25 days, and in 3 out of 5 patients with recurrent pneumothorax in 4 days. Five patients had drainage following pleurodesis for 2 to 4 weeks. The most frequent complications of thoracoscopy were subcutaneous emphysema and pain after talcum powder insufflation, the most serious being drainage for more than 7 days in 11 patients. Conclusion. Diagnostic thoracoscopy improves the diagnostics of pleural, pulmonary, mediastinal and chest wall diseases and makes a successful pleurodesis possible. Complications are rare.
Summary		Izhodišča. Torakoskopija pomaga diagnosticirati plevralne bolezni, kadar odpove neinvazivna diagnostika. Prikazane so naše so naše izkušnje s to metodo. Metode. V terospektivni študiji smo ugotavljali rezultate 138 toraksopij, opravljenih v letih 1985 do 1995. Preiskave smo delali v lokalni anesteziji. Pnevmotoraks smo napravili neposredno pred torakoskopijo in ga nadzirali z rentgenskim slikanjem. Pod kontrolo očesa smo s torakoskopom Storz odvzeli 2 do 25 vzorcev plevre za histološki in citološki pregled. Po posegu so imeli bolniki prevralno drenažo povprečno 2,9 dneva. Rezultati. S torakoskopijo smo pri 127 bolnikih razjasnili njihovo bolezen. Pri 70 bolnikih z malignomi je bila senzitivnost 93 % točnost 94 % in specifičnost 100 %. Med 21 torakoskopiranimi bolniki s pljučnim rakom in plevralnim izlivom so osmim kasneje napravili lobektomijo ali pnevmonektomijo. Pri 13 od 16 bolnikov s plevralnimi izlivi smo dosegli zlepljenje plevre s smukcem v 2,5 dneva in pri 3 do 5 bolnikov s ponavljajočim se pnevmotoraksom v 4 dneh. Pet bolnikov je bilo dreniranih po plevrodezi 2 do 4 tedne. Najbogostejši zapleti torakoskopije so bili podkožni emfizem in bolečine po vpihavanju smukca, najresnejši pa drenaža več kot 7 dni pri 11 bolnikih. Zaključki. Diagnostična torakoskopija izboljša diagnostiko bolezni plevre, pljuč, mediastinuma in prsne stene in omogoča uspešno plevrodezo. Zapleti so redki.
Descriptors		PLEURAL NEOPLASMS PLEURAL EFFUSION PNEUMOTHORAX THORACOSCOPY