Mediastinoscopy and video-assisted thoracoscopic surgery: anesthetic pitfalls and complications.
Endoscopic evaluation of the thoracic cavity was first described in 1910 when Jacobaeus used a cystoscope for pleural examination. Significant advances in thoracoscopic surgery, including the use of high-definition videoscopy and refinements in surgical technique, have created a vast array of increasingly complex procedures that can be performed. The minimally invasive nature of video-assisted thoracoscopic surgery (VATS) makes it ideal for diagnostic and therapeutic procedures in ambulatory and critically ill patients. Mediastinoscopy is often performed immediately preceding VATS to permit sampling of mediastinal lymph nodes. As the indications for thoracoscopic surgery expand, the anesthesiologist must be familiar with common anesthetic and surgical complications, which occur in up to 9% of patients.
Thomsen
Robert W
RW
Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA. rthomse1@jhmi.edu
D000758:Anesthesia / Q000009:adverse effects*; D006801:Humans; D008481:Mediastinoscopy / Q000009:adverse effects*; D012121:Respiration, Artificial / Q000379:methods*; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects*