A survey of 150 video-assisted thoracoscopic procedures in Kuwait.
OBJECTIVE
To review our experience of indications, technique, and complications as they relate to video-assisted thoracoscopic surgery (VATS) in the diagnosis and management of intrathoracic diseases.


METHODS
One hundred and fifty consecutive VATS procedures, which were performed over a 3-year period, were retrospectively evaluated. Indications included recurrent or persistent primary spontaneous pneumothorax (n = 73 patients), lung biopsies for diagnosis of diffuse lung disease (n = 33), pleural biopsies (n = 18), wedge resections of pulmonary nodules (n = 8), bilateral thoracic sympathectomy (n = 6), decortication (n = 5), mediastinal tumor biopsies (n = 5), excision of bullous emphysema (n = 1), and removal of a foreign body from the pleural cavity (n = 1). An alternative method of manipulating thoracoscopic instruments without using a trocar is described.


RESULTS
Of the 150 VATS procedures, 127 (85%) were successfully performed, 6 (4%) were converted to thoracotomy and 17 (11%) had complications. The most common complication was prolonged air leak, which occurred in 9 patients. The average postoperative hospital stay was 4 days (range: 2-17). Diagnostic procedures were considered successful in 32 out of 33 lung biopsies and in all 18 patients with pleural diseases, 8 lung nodules, or 5 mediastinal tumor biopsies. The other 86 therapeutic VATS procedures were effective in 82 (95%) patients. Four (5%) patients had a recurrence of the pneumothorax after VATS.


CONCLUSIONS
Thoracoscopy and the use of a nontrocar technique is a safe and effective method for the diagnosis and treatment of intrathoracic diseases.
Ayed
Adel K
AK
Department of Surgery, Faculty of Medicine, Kuwait University and Chest Diseases Hospital, Kuwait. adel@hsc.kuniv.edu.kw
Al-Shawaf
Emad
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods; D005260:Female; D006801:Humans; D007730:Kuwait; D008297:Male; D008875:Middle Aged; D018700:Pleurodesis / Q000379:methods; D011013:Pneumonectomy / Q000379:methods; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013562:Sympathectomy / Q000379:methods; D013896:Thoracic Diseases / Q000175:diagnosis / Q000601:surgery; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods* / Q000592:standards*; D020708:Thoracoscopes; D013997:Time Factors; D014741:Video Recording