经电视胸腔镜确诊恶性胸膜间皮瘤

目的利用电视胸腔镜对恶性胸腔积液进行诊断。方法在局麻下于患侧腋中线第8肋间隙作单一切口进行胸腔镜检查，并在直视下采取病变部位的组织送病理活检。结果7例患者均能较好地耐受胸腔镜检查，顺利取得病变组织，经病理检查证实为恶性胸膜间皮瘤。术后7例患者均无并发症。结论经胸腔镜可以直视病变，取得高质量的活检标本，安全、有效地确诊疑难胸膜疾病。

Diagnosis of malignant pleural mesothelioma by thoracoscopy

Objective: To diagnose the malignant pleural mesothelioma using the video-assisted thoracoscope. Methods: Thoracoscopy with a single opening was performed using a rigid thoracoscope under local anesthesia with neuroleptanalgesia. A total of (3~5) biopsies were taken from the parietal and/or visceral pleura in each patient. Biopsies were taken under visual control for optical microscopic examination. Results: All of 7 cases had underwent and toleranced the thoracoscopy. The most specific aspects consisted in white-yellowish nodules, almost translucent, arising from the parietal pleura (6 patients). The biopsies were taken smoothly. General pathologic examenation and immunohistochemistry confirmed the malignancy pleural mesothelioma. All of these patients had not any postoperative complication in duration of hospitalization. Conclusion: In 7 patients thoracoscopy allows complete visualization of the pleural cavity and provides high-quality biopsy samples. Therefore, the thoracoscopy is safe, simple and effective approach for diagnoses of difficult pleural effusion.