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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 1999 August;12(4):257-62
VATS major pulmonary resections. A five-year experience
Solaini L., Campanini A., Bagioni P., Di Francesco F., Poddie D. B.
Background. Aim of this paper is to present personal experience of video-assisted thoracic surgery in major pulmonary resections in the light of the results showing no differences in the outcomes for VATS and for thoracotomic surgery.
Methods. Personal 5-year experience on VATS major pulmonary resections based on 78 patients is reported. The indications for surgery were: stage I primary lung cancers (60), solitary metastases (10), undeterminate nodules not removable by wedge resections (2) and typical carcinoids (6). Sixty-five lobectomies, three bilobectomies and one pneumonectomy were performed, while in nine cases (11.5%) the procedure was converted to open thoracotomy.
Results. Ten patients (14.5%) had postoperative complications, but only one required reoperation because of hemothorax. Postsurgical pathology showed that the two patients with undeterminate nodules had tuberculoma and hamartoma; among primary tumors one bronchiolo-alveolar carcinoma and 50 NSCLC (37 stage I; 7 stage II; 3 stage IIIa; 3 no stage) were found. In a mean follow-up period of 26 months in the group of primary carcinomas there were four recurrences with two deaths and in the group of metastases there were three relapses of disease including two deaths.
Conclusions. The conclusion drawing from this experience is that in performing major pulmonary resections, VATS seems to give the same results as those carried out with open surgery, but endoscopic techniques have the advantages of the mini-invasive procedures. The best results are achieved when the indications for surgery are based on accurate patients selection and after a period of thorough surgical training.