Practical Thoracoscopy

Book excerpt: Diseases of the pleura such as effusion, thickening, or pneumothorax are frequently encountered in the practice of medicine. Practical Thoracoscopy presents an encyclopedic approach to the use of thoracoscopy in the diag nosis and treatment of patients with pleural disease. After an initial chapter on the history of thoracoscopy, the next three chapters of the book are devoted to the general technique of performing thoracoscopy, a topic on which the team of Dr. Boutin and his colleagues write with ample experience. In these chapters they provide detailed de scriptions of how to perform the procedure and discuss the pros and the cons of the different approaches and the different equipment available. The following chapter discusses the complications of the procedure. The next chapter discusses the role of thoracoscopy in diagnosing pleu ral effusions. My own opinion here is in general that, as long as well trained personnel are available, thoracoscopy is preferable to open pleural biopsy, because it is associated with less morbidity and mortality and can be done if necessary under local anesthesia. The following chapter is directed at using to thoracoscopy to facilitate pleurodesis for chronic pleural effusions. With Boutin's method, talc pou drage is performed during thoracoscopy, and certainly, if a thoracoscopy is used to establish the diagnosis of a malignant pleural effusion, it is appro priate to attempt to induce a pleurodesis with talc at the time of the diag nostic procedure.