ORGANIZATION AND IMPORTANCE OF QUALITY-CO NTROL FOR THORACOSCOPIC SURGERY

The rapid evolution or rather revolution of minimally invasive surgica l techniques is stimulating new technical and clinical innovations. Qu ality control is of great importance in new areas of technical develop ment where standards do not yet exist. By recording detailed documenta tion of patient data, indications, operative procedures and initial fo llow-up we can compare this new technology with the gold standard ther apy. This documentation system for thoracoscopic interventions was dev eloped together with the Swiss Group of Laparoscopic and Thoracoscopic Surgeons. This pilot project of 85 consecutive thoracoscopic interven tions will demonstrate the acceptability, clinical application and eas e with which data can be analyzed. Operative techniques are described in detail: 20 diagnostic interventions with biopsy, 19 apical parietal pleurectomies (+/- resections of bullous lung tissue), 10 therapeutic lung tissue resections, 19 palliative pleurodesis, 5 treatments of pl eural empyema, 1 mediastinal tumor resection, 1 esophagectomy, 4 thora cic sympathectomies plus 6 other procedures. Data entry is efficient w ith mean total time of 10 min for each record. All of the data are ent ered into a computer database. The possibilities for interpreting and combining this data are presented. The operative techniques can easily be related with history, indications, anesthesia, complications and r esults. First evaluation of thoracoscopic efficiency is possible. In a ddition, a detailed analysis of intra- and postoperative complications and of the hospital course can be performed.