Video Assisted Thoracic Surgery Study Group data

Hazelrigg, Stephen R.; Nunchuck, Susan; LoCicero, Joseph

doi:10.1016/0003-4975(95)90011-x

Cited by 170 publications

(72 citation statements)

References 7 publications

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“…In our overall experience with VATS, the treatment of PSP accounted for 47% of the procedures carried out by us. In the multicentered study of the Video Assisted Thoracic Group in the United States [28] it represented 9%.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of primary spontaneous pneumothorax with video-assisted thoracic surgery

Freixinet¹,

Canalís²,

Rivas³

et al. 1997

Eur Respir J

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We report the results of our experience using video-assisted thoracoscopic surgery (VATS) to treat primary spontaneous pneumothorax (PSP) from January 1992 until December 1994 in a multicentered co-operative study.A total of 132 patients (110 males and 22 females, aged 13-38 yrs, mean age 26 yrs) were treated by VATS to deal with the PSP that they presented with. A standard VATS technique was used. Apical bullae were always removed, and mechanical pleural abrasion was performed, leaving a pleural drainage tube.In two cases (1.5%), a switch to thoracotomy was necessary. In eight cases (6%), air leakage persisted for 5 days after surgery, which resolved with pleural drainage. There were eight postoperative relapses (6%), which were treated with pleural drainage (n=4), VATS (n=3) or axillar thoracotomy (n=1). The average postoperative stay was 5.6 days (range 2-15 days).We conclude that video-assisted thoracoscopic surgery is a viable alternative for the treatment of primary spontaneous pneumothorax. There is, however, a high relapse rate, and in a number of cases air leakage persists in the postoperative period. Eur Respir J 1997; 10: 409-411 Primary spontaneous pneumothorax (PSP) is a benign process, but persistent air leaks or recurrence make surgical intervention necessary in 30-40% of cases. PSP has come to be treated in the classic form, through axillar thoracotomy; the results published have been good, with a minimum rate of relapse and morbidity [1][2][3][4]. Recent developments in video-assisted thoracoscopic surgery (VATS) allowed a change in surgical technique, reducing surgical intervention. In order to evaluate VATS technique in PSP we initiated a multicentered study covering a period of 3 yrs. Materials and methodsBetween January 1992 and December 1994, a co-operative multicentered study was carried out by the Thoracic Surgery departments of three teaching hospitals. A total of 132 patients affected with PSP were treated by VATS. The indications for surgery for PSP were as follows: 1) persistent air leakage of more than 7 days after pleural drainage at the first episode of PSP (n=24); and 2) ipsilateral relapse in a case of PSP previously treated by pleural drainage (n=108). Cases of spontaneous pneumothorax, in which the patient had no primary pulmonary disease, were considered to have PSP.Patients treated through axillar thoracotomy during this same period of time were excluded from the study, as were patients with secondary pneumothorax, those more than 40 yrs of age (although not suspected of having basic pulmonary disease), and those of traumatic origin.The technique used was the same in all cases. It was carried out using general anaesthesia with a doublelumen endobronchial tube. Three incisions were made in order to introduce the optical equipment, the thoracic endoscopy instruments, and the endosutures. A removal of (generally apical) bullae or dystrophic complexes responsible for the episodes of pneumothorax was always performed. In cases of air leakage, air leak tests were performe...

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Section: Discussionmentioning

confidence: 99%

Surgical treatment of primary spontaneous pneumothorax with video-assisted thoracic surgery

Freixinet¹,

Canalís²,

Rivas³

et al. 1997

Eur Respir J

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“…7 Staging of lung cancer by thoracoscopy is gaining progressive support in reducing the incidence of exploration thoracotomies for inoperable cases. 8 Therapeutic applications require more skill to perform non-compromised procedures and to ensure an outcome similar to open techniques. In cases of recurrent pneumothorax or persistent air leak, apical bullectomy with pleurodesis is the treatment of choice and can be well achieved by VATS.…”

Section: Discussionmentioning

confidence: 99%

“…With the introduction of VATS, the procedure can be done bilaterally, with a short hospital stay and excellent outcome. 8 The utilization of VATS in other therapeutic procedures is still being debated. The general principle is that the procedure should not be compromised due to different access.…”

Section: Discussionmentioning

confidence: 99%

“…Pulmonary metastasectomy is widely practiced, and in our institute, we limit the use of VATS to solitary osteosarcoma and pulmonary metastasis. 8 In these selected cases, the nodule can be identified and resected safely with free resected margins. Staging of lung or esophageal carcinoma may require thoracoscopy and lymph node biopsy in selected cases.…”

Section: Discussionmentioning

confidence: 99%

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Thoracoscopic Surgery: Indications and Outcome

Alkattan¹

2000

Ann Saudi Med

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Background: Video-assisted thoracoscopic surgery (VATS) has become an established technique in both diagnostic and therapeutic thoracic surgery procedures. Patients and Methods:In an attempt to evaluate the current indications and outcome of this technique, 143 VATS procedures, which were performed over a three-year period, were retrospectively evaluated. Indications included lung biopsy in 46, recurrent or persistent pneumothorax in 42, and pleural disease in 16 patients. Other indications included sympathectomy in eight, mediastinal mass in three, pericardial window in three, metastasectomy in three, and staging of lung cancer in two patients. Results: There was one postoperative death (0.7%), a patient with massive pleural effusion and end-stage renal and hepatic failure. Conversion to formal thoracotomy was necessary in six patients (4.2%), and was the result of adhesions in four, bleeding in one, and failure to identify the lesion in one patient. Diagnostic procedures were considered successful in 44 out of 46 lung biopsies (95.7%), 15 out of 16 pleural disease cases (93.8%), and two lung cancer staging cases. The other 79 therapeutic VATS procedures were all effective, both in the long and short term, apart from two cases of prolonged air leak after VATS for pneumothorax, one of which was considered a failure (2.4%). Conclusion: VATS should be available in each thoracic surgery unit. It is both safe and effective in a variety of diagnostic and therapeutic procedures.

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“…Video-assisted thoracoscopic surgery (VATS) was first described in the early 1990's. Initial applications included chest exploration, pleural effusion or pneumothorax management, and limited resection of lung nodules [1][2][3][4]. As minimally invasive techniques improved, clinical application of VATS became progressively widespread for more complex procedures.…”

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confidence: 99%