[Incidents and complications of therapeutic thoracoscopy. Apropos of 898 operated patients].
The exceptional interest in endoscopic surgery, both in laparoscopic surgery and video-assisted thoracoscopic surgery have led many teams to widen their indications. This movement has developed into a revolution in techniques demanded by patients, the public, and the medias, requiring many practicians to use these techniques more and more often and consequently to attempt very delicate operations. This "explosion" of endoscopic techniques has largely benefited from advances in equipment development (optics, video instrumentation) but has also required that operators acquire rigorous procedures for the proposed techniques. With the development of new thoracoscopic techniques for therapeutic indications, there are an unavoidable number of incidents and complications. These incidents and complications are related both to the use of instruments undoubtedly not well enough adapted to the procedures used and also to "forced" indications. We humbly recognize that a certain number of incidents are related to the necessarily inadequate experience of the operators during the "run in" period. We emphasize that video-assisted thoracoscopic surgery is a complementary technique among the available therapeutic armamentarium. We evaluated the mid and long term results of cancerology exeresis with these two techniques and underscore that morbidity and complications are rare but sometimes unacceptable. In conclusion, whatever the form of the technique used, it is an important evolution in surgery which must abide by the classical rules, in particular for indications in cancer surgery.
Jancovici
R
R
Service de Chirurgie thoracique, hôpital du Val-de-Grace, Paris.
Dahan
M
M
Azorin
J
J
Dujon
A
A
Cador
L
L
Pons
F
F
D004724:Endoscopy / Q000009:adverse effects* / Q000401:mortality / Q000706:statistics & numerical data; D006801:Humans; D007432:Intraoperative Period; D011184:Postoperative Period; D013906:Thoracoscopy / Q000009:adverse effects* / Q000401:mortality / Q000706:statistics & numerical data; D013908:Thoracotomy / Q000009:adverse effects* / Q000401:mortality / Q000706:statistics & numerical data
Incidents et complications de la thoracoscopie thérapeutique. A propos de 898 patients opérés.