Complications of thoracoscopy

Krasna, Mark J.; Deshmukh, Sanjay; McLaughlin, Joseph S.

doi:10.1016/0003-4975(96)00021-5

Cited by 79 publications

(40 citation statements)

References 14 publications

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“…The need for conversion has been reported to be between 4.1 and 33.1%, depending on the procedure [5,6,[26][27][28]. These findings are consistent with our experience, where 4% of patients required conversion to an open procedure.…”

Section: Discussionsupporting

confidence: 82%

“…Reported in-hospital mortality rates ranged between 0 and 5% [3,7,26,27], with the deaths largely involving older patients in poor condition or with malignancy. Most surgical series have reported an incidence of 4-11% of complications resulting from VATS [3,[26][27][28]. Most of the postoperative complications seen after thoracoscopy are similar to those that occur after open procedures.…”

Section: Discussionmentioning

confidence: 81%

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A Survey of 150 Video-Assisted Thoracoscopic Procedures in Kuwait

Ayed

Al-Shawaf²

2004

Med Princ Pract

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Objective: To review our experience of indications, technique, and complications as they relate to video-assisted thoracoscopic surgery (VATS) in the diagnosis and management of intrathoracic diseases. Subjects and Methods: One hundred and fifty consecutive VATS procedures, which were performed over a 3-year period, were retrospectively evaluated. Indications included recurrent or persistent primary spontaneous pneumothorax (n = 73 patients), lung biopsies for diagnosis of diffuse lung disease (n = 33), pleural biopsies (n = 18), wedge resections of pulmonary nodules (n = 8), bilateral thoracic sympathectomy (n = 6), decortication (n = 5), mediastinal tumor biopsies (n = 5), excision of bullous emphysema (n = 1), and removal of a foreign body from the pleural cavity (n = 1). An alternative method of manipulating thoracoscopic instruments without using a trocar is described. Results: Of the 150 VATS procedures, 127 (85%) were successfully performed, 6 (4%) were converted to thoracotomy and 17 (11%) had complications. The most common complication was prolonged air leak, which occurred in 9 patients. The average postoperative hospital stay was 4 days (range: 2–17). Diagnostic procedures were considered successful in 32 out of 33 lung biopsies and in all 18 patients with pleural diseases, 8 lung nodules, or 5 mediastinal tumor biopsies. The other 86 therapeutic VATS procedures were effective in 82 (95%) patients. Four (5%) patients had a recurrence of the pneumothorax after VATS. Conclusion: Thoracoscopy and the use of a nontrocar technique is a safe and effective method for the diagnosis and treatment of intrathoracic diseases.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 81%

A Survey of 150 Video-Assisted Thoracoscopic Procedures in Kuwait

Ayed

Al-Shawaf²

2004

Med Princ Pract

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“…2 years later, KRASNA et al [68] reported a complication rate of 4% in 321 thoracoscopic procedures for all causes (121 for SPN diagnosis). In 1999, SWANSON et al [69] published the findings of a series of 65 patients with neither major complications nor failure.…”

Section: Procedural Complications Of Screeningmentioning

confidence: 99%

Screening for lung cancer: time for large-scale screening by chest computed tomography

Shlomi

Ben-Avi

Balmor³

et al. 2014

European Respiratory Journal

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Lung cancer is the leading cause of cancer death worldwide. Age and smoking are the primary risk factors for lung cancer. Treatment based on surgical removal in the early stages of the disease results in better survival. Screening programmes for early detection that used chest radiography and sputum cytology failed to attain reduction of lung cancer mortality. Screening by low-dose computed tomography (CT) demonstrated high rates of early-stage lung cancer detection in a high-risk population. Nevertheless, no mortality advantage was manifested in small randomised control trials. A large randomised control trial in the USA, the National Lung Screening Trial (NLST), showed a significant relative reduction of 20% in lung cancer mortality and 6.7% reduction in total mortality, yet no reduction was evidenced in the late-stage prevalence. Screening for lung cancer by low-dose CT reveals a high level of false-positive lesions, which necessitates further noninvasive and invasive evaluations. Based primarily on the NLST eligible criteria, new guidelines have recently been developed by major relevant organisations. The overall recommendation coming out of this collective work calls for lung cancer screening by low-dose CT to be performed in medical centres manned by specialised multidisciplinary teams, as well as for a mandatory, pre-screening, comprehensive discussion with the patient about the risks and advantages involved in the process. Lung cancer screening is on the threshold of a new era, with ever more questions still left open to challenge future studies. @ERSpublications Lung cancer screening is on the threshold of a new era, with wider application of CT screening now recommended

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“…The main reasons for changing from thoracoscopy to open thoracotomy were the inability to locate or resect deep or central lesions, pleural metastases, chest wall involvement, fibrinopurulent empyema, hemorrhage, or single-lung-ventilation failure [16]. Krasna et al [17] suggested that conventional CT failed to diagnose chest wall involvement in the majority of patients requiring a change to thoracotomy because of the poorer resolution with a slice thickness of 8 mm.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of morphological characteristics for the differentiation of benign from malignant solitary pulmonary lesions using HRCT

Seemann¹,

Staebler²,

Beinert

et al. 1999

European Radiology

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The aim of this study was to analyze different characteristics on high-resolution computed tomography (HRCT) that help differentiate benign solitary pulmonary lesions (BSPLs) from malignant solitary pulmonary lesions (MSPLs). High-resolution computed tomography was performed on 104 consecutive patients with SPLs. The whole lesion was examined with a slice thickness of 1 mm and a 12-cm field of view. All lesions were surgically excised within 24 h of the CT examination. Satellite nodules, cavitations, and necrosis were found only in MSPLs. Useful characteristics for the differentiation of BSPLs from MSPLs were the presence of spicules (p < 0.00005), spicules extending to the visceral pleura (p < 0.0005), the vessel sign (p < 0.0005), pleural retraction (p < 0.001), circumscribed pleural thickening (p < 0.001), the bronchus sign (p < 0.005), the presence of ground-glass attenuation adjacent to the SPL (p < 0.01), the density of the lesion (p < 0.05), and the length of spicules (p < 0.05). Using the significant characteristics p < 0.01 for the identification of MSPLs, a sensitivity of 91.4 % and a specificity of 56.5 % (accuracy of 83.7 %) was found. A precise morphological assessment of the periphery of the pulmonary lesion is necessary. The HRCT technique is useful in differentiation of BSPLs from MSPLs. However, metastases strongly resembled benign lesions in terms of size and edge type, and chronic inflammatory pseudotumors as a group mimic MSPLs.

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Complications of thoracoscopy

Cited by 79 publications

References 14 publications

A Survey of 150 Video-Assisted Thoracoscopic Procedures in Kuwait

A Survey of 150 Video-Assisted Thoracoscopic Procedures in Kuwait

Screening for lung cancer: time for large-scale screening by chest computed tomography

Usefulness of morphological characteristics for the differentiation of benign from malignant solitary pulmonary lesions using HRCT

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