Indications for minimally invasive thoracoscopic surgery How much does minimally invasive thoracoscopic surgery for lung cancer cost Minimally invasive surgery for esophageal cancer treatment cost Early symptoms of lung cancer How to treat early lung cancer Minimally invasive thoracoscopic surgery for early lung cancer Early symptoms of lung cancer How to treat early lung cancer Minimally invasive thoracoscopic surgery Zhu Yanjun, Department of Thoracic Surgery, Air Force General Hospital ① Pneumothorax, spontaneous pneumothorax: Spontaneous pneumothorax is mostly caused by rupture of large pulmonary alveoli caused by rupture of large alveoli. It is one of the most common conditions for which thoracoscopic surgery is performed. It is generally believed that the following cases should be considered for thoracoscopic surgery: a recurrent unilateral spontaneous pneumothorax. b persistent air leak after closed drainage of the chest (more than 7 days). c bilateral spontaneous pneumothorax with or without simultaneous occurrence. d large pulmonary alveoli that compress the lung tissue and affect the patient’s respiratory function. ② lung disease, isolated lesions in the lung [Thoracoscopic surgery has become the most safe and reliable diagnostic method for diffuse and substantial lung disease. Treatment of peri-pulmonary type lesions smaller than 5 cm: such as earlier lung cancer, adenoma, malignant tumor, inflammatory pseudotumor, tuberculoma, and tiny pulmonary nodules. Thoracoscopic resection of lung tumors can be performed first and sent for rapid cryopathological examination. In case of malignant tumor, standard radical surgery is performed under thoracoscopy, which is internationally recognized to have the same effect as ordinary open-heart surgery. Mediastinal tumors: mediastinal occupying lesions with non-invasive growth, such as thymoma, teratoma, pericardial cyst, neuronal tumor, bronchogenic cyst, lipoma, etc., can be more easily excised by thoracoscopic surgery. Especially in patients with suspected mediastinal lymphoma, a detailed cytologic diagnosis can be obtained, which is crucial to guide treatment. ④ Pericardial disease: In patients who have failed multiple punctures in the past, thoracoscopy is a reliable way to obtain a specimen of effusion. Biopsy and pericardial opening for drainage are provided. ⑤ Thoracic trauma: progressive hemothorax, tracheobronchial rupture and esophageal laceration can be clearly diagnosed and treated such as hemostasis. ⑥Tumor staging: It can better reflect the extent of mediastinal lymphatic metastasis comprehensively instead of mediastinoscopy. For example, lymph nodes under the bulge, lymph nodes in the main pulmonary artery window and para-aortic lymph nodes, which are often difficult to detect by mediastinoscopy. Thoracoscopic surgery is an excellent way to biopsy mediastinal lymph nodes. In addition, the spread of lung cancer or esophageal cancer to the adjacent mediastinal organs or chest wall can be observed through thoracoscopy. It can determine the possibility of tumor resection and avoid unnecessary open-chest exploration. (7) Pleural diseases: A pleural effusion: unexplained pleural effusion, part or all of the pleural lesions can be removed and sent for pathological examination. Lung cancer combined with malignant pleural effusion using thoracoscopic biopsy and intraoperative talc spray pleural fixation to permanently eliminate the effusion has become an international standardized treatment. B Pleural space-occupying lesions: thoracoscopic surgery can obtain an accurate pathological diagnosis by cutting sufficient tissue specimens while directly observing the lesion. ⑧ Esophageal diseases: esophageal smooth muscle tumor, cardia incontinentia, earlier esophageal cancer, can be operated via thoracoscopy. ⑨ Other diseases of the chest: thoracic sympathectomy (hand sweating), such as thoracic duct ligation, diaphragmatic hernia repair, paravertebral abscess incision and drainage, etc., thoracoscopy can provide the necessary exposure and complete the basic surgical operation. ⑩Funnel chest: using NUSS surgery without opening the chest.