Continued experience with thoracoscopic major pulmonary resection.
Between April 1992 and March 1995, 83 patients underwent video-assisted (VATS) thoracoscopic major pulmonary resection (lobectomy: 72, bilobectomy: 4, or pneumonectomy: 7). Conversion to open thoracotomy was required in a further 21 cases (rate=20.2%). There was no in unit mortality; 2 patients died within 30 days (1.9% overall). Analysis (median values) of the VATS lobectomy cases demonstrated; operation time - 135 minutes; blood loss - 80 mls; High Dependency stay - 38 hours; total postoperative stay - 7 days. Comparison between 70 VATS lobectomies and a simultaneous group of 110 open thoracotomy cases confirmed reduced postoperative morphine consumption (83 mg open vs 57 mg VATS; p<0.001). One pneumonectomy patient exhibited a transient sympathetic dysaesthesia and one lobectomy patient developed a mild post thoracotomy pain syndrome. Long-term follow-up of VATS lobectomy for patients with primary bronchogenic carcinoma (49) revealed 1 bronchogenic cancer related death during an overall mean follow-up of 16.5 months.
Walker
W S
WS
Department of Thoracic Surgery, City Hospital, Edinburgh, U.K.
Pugh
G C
GC
Craig
S R
SR
Carnochan
F M
FM
D000328:Adult; D000368:Aged; D002283:Carcinoma, Bronchogenic / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D019723:Endoscopes; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000601:surgery; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010149:Postoperative Pain / Q000209:etiology; D011013:Pneumonectomy / Q000295:instrumentation*; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D013525:Surgical Instruments; D015996:Survival Rate; D020708:Thoracoscopes; D013908:Thoracotomy; D016896:Treatment Outcome; D014741:Video Recording / Q000295:instrumentation*