抄録
In this paper we describe a new method to get a histological diagnosis from patients with lung diseases.
Our new method is performed under intubation anesthesia using an optical glass-fiber thoracoscopy through a small skin incision, of approximately 1.5cm. After having carried out the thorough observation of the lung surface with the optical glass-fiber thoracoscopy, lung biopsy is performed subsequently with forceps, looking at the lung lesion. When the biopsy is over, meticulous hemostasis of the bleeding of the lesion is then made by electrocoagulation, not by hemostats nor by ligations. And air leakage is completely subsided by applying tissue adhesive, made of cyanoacrylate, Alonalpha R. The involved lung is reflated through intratracheal tube, after ascertaining that bleeding and air leakage from the lesion is no more observed. Usually we did not use the drainage tube.
We have performed this new lung biopsy, named
“Trans-thoracoscopic lung biopsy”, on patients with various pulmonary and pleural diseases. Of all 11 biopsies performed, one revealed an alveolar cell carcinoma (disseminated type), one alveolar proteinosis, two sarcoidosis of the lung, one miliary tuberculosis, three pulmonary fibrosis, two primary pulmonary carcinoma and one metastatic pulmonary carcinoma. In each case a histological diagnosis was obtained.
We conclude that the “Trans-thoracoscopic lung biopsy” is especially indicated in cases with disseminated lung shadows, in chest Roentgenogram, as it is possible to be applied repeatedly before and after treatments.
