VIDEO-ASSISTED THORACIC-SURGERY - STAGING AND MANAGEMENT OF THORACIC TUMORS

Background: This prospective study was conducted to investigate the va lue of video-assisted thoracic surgery (VATS) for staging and therapy of thoracic tumors. Methods: VATS was performed in 86 patients present ing peripheral pulmonary nodules. Indications for thoracoscopy include d diagnosis of indeterminated pulmonary lesions (n = 55), staging of d isseminated disease (n = 24), and therapeutic interventions (n = 7), P revious or simultaneous tumors belonged to gastrointestinal tract (n = 27), sarcoma (n = 19), breast (n = 12), and miscellaneous. VATS was c arried out under general anesthesia using double lumen intubation. Res ults: VATS was successfully performed in 78% of patients. It was conve rted in 19 patients (22%) because of adhesions (n = 12), technical pro blems (n = 3), and lesions not to be found (n = 4). VATS revealed mali gnancy in 81% and benign lesions in 19%. Additional information compar ed to conventional staging was obtained in 48%, resulting in therapeut ic consequences in 34% of the patients. Postoperative complications re lated to VATS were observed in nine patients.Conclusions: In this stud y, VATS proved to be a sensitive technique for staging of pulmonary le sions. Thoracoscopic wedge resection may have significant impact on th e operative management of carefully selected patients with peripheral pulmonary lesions.