Source: Annual Congress 2001 - Thoracoscopy
Disease area: Thoracic oncology

Abstract

Background: Most literature reports dealing with complications of VAT cite an overall complication rate between 10 and 11%.
Materials and methods: From 1993 through 1999, 249 VATs have been performed in our Institution including 174 talcpoudrages, 114 adhesiolyses, 27 lung biopsies, 18 empyemectomies, 17 pericardial fenestrations, 17 partial pleurectomies, 9 bullectomies. Our main prophylactic strategies were : A) selection of patients in regard to general conditions, age, immunological status, concurrent diseases, etc. B) thorough examination of the thoracic lesion by ultrasound and radiologic techniques ; C) preoperative cyto-histological and functional investigation; D) lung expansion test in patients with pleural effusion; E) preoperative antibiotic prophylaxis; F) control of electronic and mechanical instruments.
Results: Despite conscientious use of all these measures, 14 complications have occurred : 4 partial lobar atelectases, 3 prolonged air leaks, 2 interstitial emphysemas, 2 thoracic wall fistulas, 1 infection of the thoracic cavity, 1 relapsing pleural effusion and 1 death due to terminal respiratory insufficiency.
The overall complication rate was 5.6 % (14/249).
Intracanalicular metastases in patients with pleural mesothelioma are not mentioned because not VAT-specific.
Conclusion: VAT is an indispensable procedure in pleuropulmonary diseases. If the above-mentioned steps are rigorously applied, complications can be kept to a minimum.

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Citations should be made in the following way:
A. Muti, M. Metwally, J. A. Nakhosteen (Bochum, Germany; Assiut, Egypt). Complications of video-assisted thoracoscopy (VAT) in a pulmonary unit. Eur Respir J 2001; 16: Suppl. 31, 3481

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