[The evaluation of the complications and its management in 800 patients who underwent the thoracoscopic surgery].
Thoracoscopy has been applied to almost all thoracic surgery as shown (table 1). Besides an opportunity to follow and encounter a trouble during surgery using thoracoscopy, so that it is necessary to become skilled in the prediction and management of complication. Nowadays, there are two options on surgery using thoracoscopy, thoracoscopic surgery (TS) is performed only on in a port and on a mini-thoracotomy with a few ports (video-assisted thoracoscopic surgery: VATS). When changing into emergency or converting into open thoracotomy, a muscle sparing thoracotomy could be available. The symptoms which occurred in the thorax are fundamentally similar during both TS and VATS procedure. However, peculiar dangerous factor existed according to the difference in internal organs, procedures, and diseases. Critical complications during surgery were as follows, i.e., injury of pulmonary vessels and bronchus, tension pneumothorax of the opposite lung and tumor implantation of the chest wall. Basically, standard practice is the most important to avoid an accident and determine whether converting to open thoracotomy should be employed. In the present commentary, we would like to present our experiences and propose regarding management.
Department of Surgery II, Nippon Medical School, Tokyo, Japan.
K
K
Koizumi
T
T
Hirata
K
K
Hirai
I
I
Mikami
M
M
Fukushima
H
H
Kubokura
S
S
Yamagishi
S
S
Haraguchi
H
H
Akiyama
N
N
Yoshino
D
D
Okada
K
K
Shimizu
D001980:Bronchi / Q000293:injuries; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control*; D008171:Lung Diseases / Q000601:surgery*; D055370:Lung Injury; D011013:Pneumonectomy / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D011651:Pulmonary Artery / Q000293:injuries; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects; D013906:Thoracoscopy / Q000009:adverse effects*