医师的胸腔镜检查:实用指南
Edited by D.R. Buchanan, E. Neville
Published by Arnold, London
第166页。价格:£24.99,€37.56。ISBN 0-340-74211-9
This is the first book published in the UK on the topic of what is otherwise known as “medical thoracoscopy” or “pleuroscopy”. A. Matthews from Portsmouth is given the credit for advocating this technique in the UK, and the authors of this contribution have been trained by him.
The book concentrates on the currently leading indications for “thoracoscopy for physicians”, and on its diagnostic and therapeutic use in pleural effusions, including early empyema.
More than one-third of the book is devoted to the evaluation of the undiagnosed pleural effusion, to the differential diagnosis of pleural effusions, and to the different possibilities of investigating the pleural fluid. Furthermore, it describes the value of different imaging techniques and of closed pleural biopsy with or without image-guidance.
One chapter deals with the technique of medical thoracoscopy, which is performed in local anaesthesia, favouring the single-puncture technique. The authors apparently prefer the supine position with the patient on their back, as well as the midaxillary line at the fourth or fifth interspace. However, they admit that the lateral decubitus position (which is preferred by most pleuroscopists) often allows improved visualisation of the whole pleural cavity.
Further chapters describe different pleurodesis methods, including thoracoscopic talc poudrage, possible complications and their management, as well as a clinical risk assessment which intends to reduce the risk of medical thoracoscopy. Each chapter is followed by a list of the latest references and recommendations for further reading.
In addition, chapters on “Current practice in video-assisted thoracic surgery” and on “Pathological findings” are included, although one would like more and technically better endoscopic photos of different typical entities.
This book describes the safety and ease of medical thoracoscopy, it is indeed a practical guide, and will certainly contribute to the more widespread application of the technique in the UK and some other parts of the world, where it is under-used at the moment. The book can be highly recommended to pulmonary physicians in training
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