EFFICACY AND SAFETY OF THORACOSCOPY FOR DIAGNOSIS AND TREATMENT OF INTRATHORACIC DISEASE - THE UNIVERSITY-OF-MARYLAND EXPERIENCE

Thoracoscopy has become an important tool in the diagnosis and managem ent of intrathoracic disease. Between April 1991 and October 1992, 93 patients underwent thoracoscopy. Lung resection was performed on ninet een patients for diagnoses of interstitial lung disease and on seven p atients for pulmonary nodules. Eleven patients underwent therapeutic l ung resection for management of pneumothorax or air leaks. Sixteen pat ients underwent thoracoscopy for pleural disease. This was to diagnose mesothelioma (2), to lyse benign adhesions (2), to drain empyema (2), and to evacuate loculated pleural effusion (10) thoracoscopically. Ni ne patients underwent thoracoscopic staging for lung cancer. Thirteen patients underwent thoracoscopic staging for esophageal cancer as part of a prospective trial. Other indications for thoracoscopy included p ericardiectomy (6), sympathectomy (2), and resection of mediastinal ma ss (4). Thoracoscopy is an excellent option for patients at high risk from standard thoracotomy and may allow procedures to be performed whi ch would prevent the need for open thoracotomy, resulting in shorter h ospital stay and less postoperative pain.