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This paper reports the findings of a prospective multicenter study whose main objective was to determine the indications for video-assisted thoracoscopic surgery (VATS), as well as the techniques used, results and complications.Seventeen chest surgery units provided data on 1,573 procedures performed over a period of two years (July 1996 to July 1998).Spontaneous pneumothorax (45.4%), lung biopsy (18.4%), pulmonary nodes (13.3%) and thoracic sympathectomy (5.3%) accounted for over 80% of the indications for VATS. An assistive mini-thoracotomy was required in 5.6%. A change to standard thoracotomy was needed in 167 cases (10.6%). Complications were observed in 10.8%, persistent air leakage being the most important. Spontaneous pneumo-thorax recurred in 17 cases (2.4%). Ten patients (0.6%) died.Technological developments have led to new applications for VATS as well as improved outcome for the most common, well established indications. It is advisable to continue to perform prospective, randomized, controlled trials to validate techniques for which little experience has accumulated. |
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