Video-Assisted Thoracic Surgery: Has Technology Found its Place?

Mack, Michael J.; Scruggs, Granger R.; Kelly, Kevin M.; Shennib, Hani; Landreneau, Rodney J.

doi:10.1016/s0003-4975(97)00247-6

Cited by 91 publications

(49 citation statements)

References 10 publications

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“…Bronchoplastic techniques or sleeve resections were described in the 1950s and allowed the preservation of normal lung distal to a tumour. Video-assisted thoracoscopic techniques have been used since the 1980s for many procedures, and, although they are now being used to perform lung resections [1], they have not been widely accepted as an adequate alternative to thoracotomy in the management of pulmonary malignancy [2].…”

mentioning

confidence: 99%

The pathogenesis of lung injury following pulmonary resection

Jordan¹,

Mitchell²,

Quinlan³

et al. 2000

Eur Respir J

235

115

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Postpneumonectomy pulmonary oedema (PPO) develops in~5% of patients undergoing pneumonectomy or lobectomy, and has a high associated mortality (>50%). In its extreme form, PPO follows a clinical and histopathological course indistinguishable from acute respiratory distress syndrome.Perioperative fluid overload, impaired lymphatic drainage following node dissection and trauma caused by surgical manipulation have been implicated in the pathogenesis of PPO. However, PPO more probably represents the pulmonary manifestation of a panendothelial injury consequent upon inflammatory processes induced by the surgical procedure, which involves collapse and re-expansion of the operative lung to permit hilar dissection and pulmonary resection.High inspired oxygen concentrations are required to overcome the effects of shunt. Animal studies have shown that pulmonary ischaemia/reperfusion can result in oedema formation, possibly due to the generation of pro-oxidant forces. Moreover, plasma taken from patients undergoing lobectomy or pneumonectomy (but not lesser resections) shows evidence of oxidative damage.Such evidence suggests either that the high inspired oxygen concentrations associated with one-lung ventilation, or ischaemia/reperfusion injury, may modulate postpneumonectomy pulmonary oedema. Mechanisms by which redox imbalance may result in tissue damage and postpneumonectomy pulmonary oedema are discussed. Eur Respir J 2000; 15: 790±799.

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mentioning

confidence: 99%

The pathogenesis of lung injury following pulmonary resection

Jordan¹,

Mitchell²,

Quinlan³

et al. 2000

Eur Respir J

235

115

View full text Add to dashboard Cite

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“…Since the advent of minimally invasive surgical techniques in thoracic surgery in 1990, Video Assisted Thoracoscopic Surgery (VATS) has become the approach for many thoracic operations [6]. The major conceptual change leading to this development was the realization that adequate intrathoracic visualization can be obtained without a large incision because of improved video equipment and that manipulative techniques can often be modified to safely achieve the same results previously obtained only through large incisions [7].…”

Section: Video Assisted Thoracoscopic Surgery (Vats)mentioning

confidence: 99%

ICD Versus VATS as Primary Treatment in Fibrinopurulent Stage of Empyema Thoracis

Nandeesh¹,

Sharathchandra

Thrishuli

2013

JCDR

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Background and Objectives: Empyema thoracis is a condition in which pus collects in the pleural cavity. The optimal treatment of Empyema thoracis especially in the fibrinopurulent phase (Stage II) remains controversial. While the Inter Costal Drainage (ICD) is less invasive and cheap, it is not clearly proved that it is better than the Video Assisted Thoracoscopic Surgery (VATS) in terms of conversion into thoracotomy, morbidity and duration of hospital stay. No large randomized trial is available for comparing the two treatment strategies in the condition. Methodology:This study was a prospective comparative study of ICD insertion versus VATS as primary intervention in the fibrinopurulent stage of Empyema thoracis, which was conducted over a period of 2 years (Dec 2008 to Nov 2010), in a tertiarry care Medical College Hospital. With an incidence of around 5-10% and a considerable burden in our hospital, the study was taken up to compare the efficacy of ICD versus VATS, in terms of morbidity and cost effectiveness and to identify the optimal way of managing the condition. The study included a total of 40 patients with each group consisting of 20 patients. Sampling: Purposive sampling technique.The Statistical Methods Used: Descriptive statistics, Frequencies, Crosstabs, Independent sample t-test.Results: It was found that VATS was better than the conventional ICD insertion in terms of the variables like mean duration of hospital stay (p<0.05), mean duration of the chest tube in situ (p<0.05), mean cost of the treatment (p<0.05), complications (p<0.05) and failure rate (p<0.05) which were statistically significant. Conclusion:Our study concluded that Video Assisted Thoracoscopic Surgery is better than conventional ICD tube insertion as a primary mode of treatment in the fibrinopurulent stage of Empyema thoracis.

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“…Without doubt, these reports slowed the general acceptance of VATS lobectomy by surgeons in some countries for a number of years. Unsurprisingly, a survey of the General Thoracic Surgery Club members in 1997 showed that the majority considered this application unacceptable (Mack et al, 1997). In that survey, 60% of respondents used VATS less than 20% of the time and 38.1% expressed concern regarding overuse.…”

Section: The Rise and Fall Of Early Vats Lobectomymentioning

confidence: 99%

“…As mentioned above, the focus of these early doubts on the oncologic efficacy of VATS lobectomy included: whether VATS allowed fine anatomical dissection for individual isolation-ligation of the hilar structures; whether VATS was a cost-effective means of delivering oncologic therapy; and whether VATS gave adequate clearance for oncological lung resections (Mack et al, 1997). The concern over the ability of VATS to allow lobectomy using an individual isolation-ligation strategy has been resoundingly answered by almost two decades of successful surgery around the world.…”

Section: The Oncologic Efficacy Of Vats Lobectomymentioning

confidence: 99%

The Evolution of VATS Lobectomy

Sihoe¹

2012

Topics in Thoracic Surgery

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Video-Assisted Thoracic Surgery: Has Technology Found its Place?

Cited by 91 publications

References 10 publications

The pathogenesis of lung injury following pulmonary resection

The pathogenesis of lung injury following pulmonary resection

ICD Versus VATS as Primary Treatment in Fibrinopurulent Stage of Empyema Thoracis

The Evolution of VATS Lobectomy

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