Imperatori Andrea, Rotolo Nicola, Gatti Matteo, Nardecchia Elisa, De Monte Lavinia, Conti Valentina, Dominioni Lorenzo
Center for Thoracic Surgery, University of Insubria, Viale Borri 57, 21100 Varese, Italy.
Int J Surg. 2008;6 Suppl 1:S78-81. doi: 10.1016/j.ijsu.2008.12.014. Epub 2008 Dec 13.
Video-assisted thoracoscopic surgery (VATS) has multiple indications for diagnosis and treatment of many different thoracic diseases; the commonest are lung wedge resection, pleural and mediastinal biopsy, treatment of pneumothorax, and pleurectomy. Moreover, in recent years a few surgeons have performed routinely major lung anatomic resections by VATS approach, including segmentectomy, lobectomy and pneumonectomy. In our experience VATS constitutes about one-third of all thoracic surgical procedures. In the reviewed literature as in the most frequent complications after VATS procedures are: prolonged air leak, bleeding, infection, postoperative pain, port site recurrence and the need to convert the access in thoracotomy. The complication and mortality rates are generally very low and VATS procedures are considered safe and effective. It is recommended that all thoracic surgery departments audit their VATS procedures for peri-operative morbidity and mortality to compare results and outcomes.
电视辅助胸腔镜手术(VATS)在诊断和治疗多种不同的胸部疾病方面有多种适应证;最常见的是肺楔形切除术、胸膜和纵隔活检、气胸治疗以及胸膜切除术。此外,近年来一些外科医生常规通过VATS方法进行主要的肺解剖性切除,包括肺段切除术、肺叶切除术和全肺切除术。根据我们的经验,VATS约占所有胸外科手术的三分之一。在综述文献中,VATS手术后最常见的并发症有:漏气时间延长、出血、感染、术后疼痛、切口部位复发以及需要转为开胸手术。并发症和死亡率通常非常低,VATS手术被认为是安全有效的。建议所有胸外科对其VATS手术的围手术期发病率和死亡率进行审核,以比较结果和疗效。