[Thoracoscopic major pulmonary resection--pro and con].

The first reports of thoracoscopic video-assisted procedures are from 1993. The main reason for this new techniques was that they allow the performance of standard thoracic surgical procedures in a less invasive ways. The operation trauma is minimalised that could be a cause not only of postoperative pain but often also of chronic future problems. The other advantages are the shortened hospitalisation time and earlier end of disablement. On the other hand there are many objective arguments against here. Firstly, the operative technique is not standardised and thoracoscopic lobectomy and pneumonectomy are performed by many modified methods. No regular randomised studies are available that could confirm the positive contribution of thoracoscopy in these cases. It is possible to perform classic thoracotomy by very careful way saving muscles and contemporary observing the requirement of safe operation and to attain the maximally possible result. Resuming information from written and verbal reports in last 3 years we have necessary the impression that the main reason for thoracoscopic reactions was to demonstrate the technical feasibility of this operation which is entirely insufficient reason for acceptance of this technique. Authors suggest that thoracoscopy is in experienced hands and adequately equipped workplaces an accurate and safe method for the diagnosis and in some cases also for therapy of hemodynamic stabile patients with thoracic trauma.