Video-Assisted Thoracoscopy is Feasible Under Local Anesthesia

Video-assisted thoracoscopy (VAT) is usually performed under general anesthesia (GA). We performed an analysis to determine whether multithoracoport VAT under local anesthesia (LA) is feasible.

Forty-five VAT under LA were performed in 34 men and 11 women (mean age 46.8 years) in the endoscopy room.

The waiting time for VAT under LA was 0.5-6h on working days. There were no major complications during or after the VAT. In 9 patients, pleural malignancy was diagnosed, and in 7 patients suspected malignancy was excluded. In 5 patients we found bacterial empyema, of whom 4 had diathermic adhesiolysis during VAT. In 4 patients, the clinical diagnosis was tuberculosis by exclusion, and in 2 patients no conclusive diagnosis could be drawn. VAT influenced treatment policy 15 times, and in 17 pneumothorax patients talc poudrage was performed during the procedure.

VAT under LA is safe, effective, logistically simple, and requires no long waiting times. No conversion to GA was necessary.