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Diagnostische videoassistierte Thorakoskopie

Video-assisted diagnostic thoracoscopy

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Zusammenfassung

Moderne bildgebende Verfahren zeigen eine Vielfalt pathologischer Veränderungen in Mediastinum, Pleura und Lunge, ohne jedoch eine Aussage über deren Histogenese zu erlauben. Transbronchiale und transthorakale Nadelbiopsien haben aufgrund ihrer Größe häufig Probleme in der endgültigen diagnostischen Klärung. Ausreichend große, repräsentative Proben können durch die videoassistierte Thorakoskopie (VATS) gewonnen werden. Damit ist die Diagnosesicherung diffuser Lungenparenchymerkrankungen, Pleuraerkrankungen einschließlich des Pleuramesothelioms, des unklaren peripheren Lungenrundherdes und vieler unklarer Mediastinaltumoren sicher und schnell möglich. Auch kann das Management des Thoraxtraumas mit dieser Methode schonend und richtungsweisend für den Patienten erfolgen. Die VATS, die in Thorakotomiebereitschaft durchgeführt wird, ist in der Hand des erfahrenen Thoraxchirurgen ein sicheres, zielführendes und effektives diagnostisches Instrument. Nicht zuletzt spielt die Interpretation des intraoperativen Befundes bei der häufig interdisziplinär gestellten Diagnose vieler intrathorakaler Erkrankungen eine wichtige Rolle.

Abstract

Modern radiologic diagnostics show a variety of pathological changes in the mediastinum, pleura, and lung but no evidence on their histogenesis. Transbronchial and transthoracal fine-needle aspiration biopsy usually cannot yield detailed diagnostic results because of its small size. Sufficient and representative material can be obtained by thoracoscopy. Video-assisted thoracoscopy allows safe and fast diagnosis of diffuse lung diseases, pleural diseases including malignant mesothelioma, indeterminate peripheral lung nodule, and mediastinal masses. This gentle diagnostic method can give invaluable information guiding further management of the thoracic injury. Video-assisted thoracoscopy is a safe and effective guiding tool if performed by experienced thoracic surgeons able to convert to thoracotomy. It is to be noted that interpretation of intraoperative findings plays a decisive role in interdisciplinary diagnostics of intrathoracal diseases.

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Es besteht kein Interessenkonflikt. Der korrespondierende Autor versichert, dass keine Verbindung mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, besteht. Die Präsentation des Themas ist unabhängig und die Darstellung der Inhalte produktneutral.

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Authors and Affiliations

  1. Klinik für Thoraxchirurgie, Dr-Horst-Schmidt-Kliniken, Ludwig-Erhardt-Str. 100, 65199 , Wiesbaden

    T. Bergmann, S. Bölükbas, S. Beqiri & J. Schirren

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  1. T. Bergmann
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  2. S. Bölükbas
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  3. S. Beqiri
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  4. J. Schirren
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Correspondence to T. Bergmann.

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Bergmann, T., Bölükbas, S., Beqiri, S. et al. Diagnostische videoassistierte Thorakoskopie. Chirurg 77, 998–1006 (2006). https://doi.org/10.1007/s00104-006-1244-x

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  • DOI: https://doi.org/10.1007/s00104-006-1244-x

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