Endoscopic Surgery of the Broncho-esophageal Diseases. Thoracoscopic Surgery: Especially in Cases of Spontaneous Pneumothorax.

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Thoracoscopic surgery has increased due to the improvement in video endoscopic surgical equipment and technique. From March 1992 to October 1995, 183 patients underwent thoracoscopic surgery at our hospital. 112 cased had spontaneous pneumothorax, 31 mediastinal tumor, 17 mediastinal disease. 11 diffusse intersitial lung disease, 7 pleural disease and 5 giant bulla. <BR>In the patients with benign mediastinal tumors (seven cases), we easily resected the tumors, but in four of the ten cases of mediastinal biopsy, we had to covert to open thoracotomy. The procedure for diffuse interstitial lung disease and pneumothorax, a wedge resection of the lung, was performed using an endoscopic stapling device (Endo-GIA) . 125 operations in 112 cases of spontaneous pneumothorax were performed. 15 cases were needed to convert to open thoracotomy due to multiple bullae in six cases, severe adhesion in three, and so on. The postoperative recurrence rate in spontaneous pneumothorax was approximately 10%. Reoperation was carried out in six cases (ten times) . In five cases, reoperation was carried out using only thoracoscopic procedures. <BR>We conclude that thoracoscopic surgery for spontaneous pneumothorax is warranted, but careful observation and exploration during operation during operation are necessary.
特定非営利活動法人日本気管食道科学会の論文