Complications of video-assisted thoracic surgery: A five-year experience

• Published in: The Annals of thoracic surgery Vol. 61; no. 2; pp. 533 - 537
• Main Authors: Jancovici, René, Lang-Lazdunski, Loïc, Pons, François, Cador, Louis, Dujon, Antoine, Dahan, Marcel, Azorin, Jacques
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.02.1996; Elsevier Science
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Chylothorax - etiology; Endoscopy - adverse effects; Endoscopy - mortality; Female; Humans; Infection - etiology; Lung Neoplasms - complications; Lung Neoplasms - surgery; Male; Mediastinal Neoplasms - complications; Mediastinal Neoplasms - surgery; Medical sciences; Middle Aged; Nervous System Diseases - etiology; Pleural Effusion - etiology; Pleural Effusion - surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the respiratory system; Survival Rate; Thoracoscopy - adverse effects; Thoracotomy - adverse effects; Thoracotomy - mortality; Videotape Recording; Human; Associated technique; Treatment; Respiratory disease; Surgery; Complication; Endoscopy; Thoracoscopy
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/0003-4975(95)01060-2

Although thoracoscopy was originally described in 1910, recent developments in video-assisted surgical techniques and endoscopic equipment has expanded the application of video-assisted surgical procedures in the field of thoracic surgery. In an effort to define both high-risk patients for video-assisted thoracic procedures and high-risk video-assisted thoracic surgical procedures, we reviewed the experience of four surgical institutions from June 1991 through May 1995. We looked specifically at complications resulting from the 937 video-assisted thoracic procedures performed during this period. Perioperative incidents or complications occurred in 35 patients (3.7%), and 116 procedures (12.4%) were converted to a thoracotomy. The in-hospital mortality rate was 0.5%, and death occurred principally in patients operated on for malignant pleural effusion. The overall incidence of postoperative complications was 10.9%, and the most prevalent complications were prolonged air leak (6.7%) and pleural effusion (0.7%). The incidence of complications was acceptable and, except for that of prolonged air leak, did not differ significantly from that resulting from analogous open procedures. Video-assisted thoracic surgery appears safe and particularly useful for some indications. However, the possibility of dramatic life-threatening perioperative complications requiring emergency conversion to thoracotomy justifies the fact that only trained thoracic surgeons should perform video-assisted thoracic surgical procedures.