[Indications and limits of thoracoscopy in surgical diagnosis and therapy of lung diseases].

Thoracoscopy is an invasive form of endoscopy which, however, can be performed with the patient in local anaesthesia. Hence, when it comes to patients, for example, in somewhat advanced age and thus with the surgical risk clearly increased, it can be used as the smallest possible intervention to clear up causes of effusions of unknown origin and can thus be helpful in avoiding an otherwise necessary operation with all associated possible complications. It can be also used in many cases to clear up new growths in the thoracic wall of the mediastinum or diaphragm or, just as well, diffuse or locally delimited pulmonary diseases. When it comes to spontaneous pneumothorax, thoracoscopy should be restricted to selected cases because of relatively high rates of recurrence. Surgical indications in such cases should be handled with more generosity. Thoracoscopy is not indicated in cases of bullae of large size or radiological detectability. Here, thoracotomy should be the option.