MAJOR PULMONARY RESECTION BY VIDEO-ASSISTED MINI-THORACOTOMY - INITIAL EXPERIENCE IN 35 PATIENTS

Video-assisted thoracic surgery is emerging as a viable approach to in creasingly complex intrathoracic therapeutic procedures. From February to July 1993, 35 patients (25 male, 10 female; mean age = 60 years, r ange: 17-74) underwent a major pulmonary resection using a video-assis ted technique: lobectomy (n = 30) or pneumonectomy (n = 5). Pathology disclosed bronchogenic carcinomas (n = 26), metastases (n = 3), and mi scellaneous disorders (n = 6). All procedures required one 10.5 mm por t for the video-camera, one 3.5 to 5 cm utility thoracotomy through wh ich surgical instrumentation was inserted and the operative specimen r emoved, and one occasional supplementary 12 mm port. Lung resections w ere performed with separated dissection and division of each component of the pedicle. The mean operative time was 145 min (SD: +/- 17). The re were two postoperative deaths (5.7%) that were not directly related to the technique. Seven patients (20%) experienced non-fatal complica tions. After lobectomy, the mean duration of chest tube placement was 7.3 days (SD: +/- 1.6). The mean hospital stay was 11 days (SD: +/- 3) . All the patients experienced minor postoperative chest pain. We conc lude that video-assisted lung resections are technically feasible with out an increased risk.