VIDEO-ASSISTED THORACIC-SURGERY - INDICAT IONS AND LIMITATIONS

From November 1990 to September 1992, 72 patients underwent a video-as sisted thoracic surgery (VATS), 47 men and 25 women, of mean age 49 ye ars. Video-assisted thoracic surgery was indicated for the following: 44 spontaneous pneumothorax, 6 benign tumors of the lung or the medias tinum, 4 pleural effusions, one broncho-pleural fistula and one sympat hectomy; 17 diagnostic procedures (lung or mediastinal lymph-nodes bio psies). In one patient, it was necessary to associate a mini-thoracoto my and 5 patients went on to a formal thoracotomy. There was no mortal ity and the morbidity rate was 5.5 %. Some conditions are required : o ne-lung ventilation, ability to convert to a formal thoracotomy at any moment. It is contra-indicated in cases of single lung or complete ob literation of the pleural space due to dense adhesions. The place of V ATS is now well defined for the treatment of spontaneous pneumothorax. It is discussed for resection of pulmonary diseases depending on thei r size, location and histologic type.