title: Thoracoscopy in pleural effusion--two techniques: awake single-access video-assisted thoracic surgery versus 2-ports video-assisted thoracic surgery under general anesthesia.
abstract: Awake single access video-assisted thoracic surgery with local anesthesia improves procedure tolerance, reduces postoperative stay and costs.
  
  
  METHODS
  Local anesthesia was made with lidocaine and ropivacaine. We realize one 20 mm incision for the 'single-access', and two incisions for the '2-trocars technique'.
  
  
  RESULTS
  Mortality rate was 0% in both groups. Postoperative stay: 3 dd ± 4 versus 4 dd ± 5, mean operative time: 39 min versus 37 min (p < 0.05). Chest tube duration: 2dd ± 5 versus 3 dd ± 6.
  
  
  RESULTS
  11/95 versus 10/79.
  
  
  CONCLUSIONS
  Awake technique reduce postoperative hospital stay and chest drainage duration, similar complications and recurrence rate. The authors can say that 'awake single-access VATS' is an optimal diagnostic and therapeutic tool for the management of pleural effusions, but above extends surgical indication to high-risk patients.
authors.affiliation: Department of Thoracic Surgery, University of Palermo, Piazza delle Cliniche, Palermo, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Cajozzo
authors.affiliation: Department of Thoracic Surgery, University of Palermo, Piazza delle Cliniche, Palermo, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Lo Iacono
authors.affiliation: Department of Thoracic Surgery, University of Palermo, Piazza delle Cliniche, Palermo, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Raffaele
authors.affiliation: Department of Thoracic Surgery, University of Palermo, Piazza delle Cliniche, Palermo, Italy.
authors.forename: Antonino Alessio
authors.initials: AA
authors.lastname: Anzalone
authors.affiliation: Department of Thoracic Surgery, University of Palermo, Piazza delle Cliniche, Palermo, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Fatica
authors.affiliation: Department of Thoracic Surgery, University of Palermo, Piazza delle Cliniche, Palermo, Italy.
authors.forename: Girolamo
authors.initials: G
authors.lastname: Geraci
authors.affiliation: Department of Thoracic Surgery, University of Palermo, Piazza delle Cliniche, Palermo, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Dioguardi
mesh_terms: D000368:Aged; D000768:Anesthesia, General / Q000379:methods; D015505:Chest Tubes; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010996:Pleural Effusion / Q000601:surgery*; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*
keywords: VATS; awake VATS; pleural effusion; single port