Predictors of general complications after video-assisted thoracoscopic surgical procedures.
BACKGROUND
The video-assisted thoracoscopic approach has become the preferred method for many procedures due to the reduced trauma, complication rate and morbidity. The aim of this study was a risk evaluation of patients undergoing video-assisted thoracoscopic surgery (VATS) procedures.


METHODS
Between 1991 and 2004, 1,008 patients were included in this single-center retrospective analysis. Risk assessment was performed using univariate and multivariate analysis.


RESULTS
Multivariate analysis revealed that patient age (p = 0.003), the duration of the VATS procedure (p = 0.008), redo-VATS (p < 0.001) and conversion to open thoracotomy (p < 0.001) correlated significantly with the incidence of complications. Patients with immune deficiency following organ transplantation had the highest complication rate at 31.7%, which was significantly higher than for patients with either benign disease (p = 0.010) or malignant disease (p = 0.019).


CONCLUSIONS
VATS is a safe procedure, but extra caution is recommended for patients with a higher risk profile (age, redo-VATS, immune deficiency).
Winter
Hauke
H
Department of Surgery and Thoracic Surgery, Klinikum Grosshadern, Ludwig Maximilians University, Munich, Marchioninistrasse 15, 81377, Munich, Germany. hauke.winter@med.uni-muenchen.de
Meimarakis
Georgios
G
Pirker
Matthias
M
Spelsberg
Fritz
F
Kopp
Reinhard
R
Rüttinger
Dominik
D
Loehe
Florian
F
Jauch
Karl-Walter
KW
Hatz
Rudolf
R
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011336:Probability; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D016019:Survival Analysis; D013896:Thoracic Diseases / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects* / Q000379:methods; D013908:Thoracotomy / Q000009:adverse effects / Q000379:methods