Role of videoendoscopy in pulmonary surgery: present experience

Videothoracoscopic techniques were utilized in managing 88 consecutive patients. The series was composed of 36 patients with pneumothorax, 44 cases of single and 9 of multiple pulmonary nodules and 1 patient with diffuse lung disease. In 14 cases (15.9%) conversion to open thoracotomy was necessary while in the remaining 74 patients the procedure (30 blebectomies, 2 bullectomies, 37 wedge resections, 6 lobectomies and one multiple biopsies) were carried out as planned. In each lobectomy and in six wedge resections an accessory small incision was necessary; we consider only this video-assisted thoracic surgery (VATS). Benign disease, aside from the blebs and bullae, was found in 12 cases of solitary pulmonary nodules and in 1 case of multiple lesions, while malignant lesions were detected in 31 patients. Primary carcinoma was diagnosed in nine cases after a wedge resection had been performed on a suspicious solitary nodule. In two of these wedge resection had to suffice because of poor lung function, while in the remaining seven cases, a lobectomy was carried out through an open thoracotomy in two patients, and in five cases VATS was attempted successfully in four, while in one case a formal thoracotomy was necessary due to bleeding. Solitary metastases were found in 14 patients and were managed by 12 wedge resections and 2 lobectomies. Seventy-one patients (97.3%) had an uneventful postoperative course while 2 (2.7%) had only minor complications. No recurrences were observed, however follow-up is limited. Videothoracoscopy techniques are very useful and are good alternatives to conventional thoracotomy in managing cases of pneumothorax, benign pulmonary lesions and in taking biopsies.(ABSTRACT TRUNCATED AT 250 WORDS)