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Video-assisted thoracic surgery (VATS) of the lung

Analysis of intraoperative and postoperative complications over 15 years and review of the literature

Abstract

Background

Video-assisted thoracic surgery (VATS) in the diagnosis and treatment of pulmonary diseases has been used since the early 1990s, yet its impact on intraoperative and postoperative morbidity has not yet been fully evaluated. This report aims to provide a retrospective analysis of the literature and the authors’ clinical experience with VATS in pulmonary surgery, with the goal of ascertaining rational criteria that explain operative complications and thus improve outcomes.

Methods

Over a period of 15 years 1,615 VATS procedures were performed in our department, 743 of which involved only the lung. The accesses employed were based on the use of three ports through which a thoracoscope, endoscopic instruments, and an endostapler were inserted; for major pulmonary resections, a utility thoracotomy without rib spreader was added. Resections less than segmentectomy were performed using the endostapler directly on the parenchyma, whereas in the anatomic resections all the hilar structures were isolated and separately sectioned.

Results

The procedures performed were as follows: surgical biopsy, 98; wedge resection, 412; segmentectomy, 15; lobectomy, 217; pneumonectomy, 1. Besides the cases in which there were intraoperative complications that could be resolved thoracoscopically, it was necessary to convert to open surgery in 80 patients (10.8%): in 24 (3.3%), for general reasons linked to the technique of VATS itself; in 56 (7.5%), for specific causes correlated to the type of exeresis. The overall postoperative morbidity rate was 8.3% with no deaths.

Conclusions

The analysis of the literature and our experience show that VATS is a reliable approach to the diagnosis and treatment of pulmonary diseases with low complication rate. To further reduce intraoperative and postoperative morbidity, however, it is necessary to select the patients carefully, to adhere strictly to oncological surgical principles, and to adopt a meticulous technique. Although conversion to open surgery represents failure of VATS, it is mandatory when the procedure is not completely safe.

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References

  1. 1.

    Allen MS, Deschamps C, Jones DM, Trastek VF, Pairolero PC (1996) Video-assisted thoracic surgical procedures: the Mayo experience. Mayo Clin Proc 71:351–359

    Article  CAS  PubMed  Google Scholar 

  2. 2.

    Ang KL, Tan C, Hsin M, Goldstraw P (2003) Intrapleural tumor dissemination after video-assisted thoracoscopic surgery metastasectomy. Ann Thorac Surg 75:1643–1645

    Article  PubMed  Google Scholar 

  3. 3.

    Anraku M, Nakahara R, Matsuguma H, Yokoi K (2003) Port site recurrence after video-assisted thoracoscopic resection of chest wall schwannoma. Interact CardioVasc Thorac Surg 2:483–485

    Article  PubMed  Google Scholar 

  4. 4.

    Ayed AK (2003) Video-assisted thoracoscopic lung biopsy in the diagnosis of diffuse interstitial lung disease. A prospective study. J Cardiovasc Surg (Torino) 44:115–118

    CAS  Google Scholar 

  5. 5.

    Bensard DD, McIntyre RC Jr, Waring BJ, Simon JS (1993) Comparison of video thoracoscopic lung biopsy to open lung biopsy in the diagnosis of interstitial disease. Chest 103:765–770

    Article  CAS  PubMed  Google Scholar 

  6. 6.

    Bernard A and the Thorax Group (1996) Resection of pulmonary nodules using video-assisted thoracic surgery. Ann Thorac Surg 61:202–205

    Article  CAS  PubMed  Google Scholar 

  7. 7.

    Bingisser R, Zollinger A, Hauser M, Bloch KE, Russi EW, Weder W (1996) Bilateral volume reduction surgery for diffuse pulmonary emphysema by video-assisted thoracoscopy. J Thorac Cardiovasc Surg 112:875–882

    Article  CAS  PubMed  Google Scholar 

  8. 8.

    Buhr J, Hurtgen M, Kelm C, Schwemmle K (1995) Tumor dissemination after thoracoscopic resection for lung cancer. J Thorac Cardiovasc Surg 110:855–856

    Article  CAS  PubMed  Google Scholar 

  9. 9.

    Caccavale RJ, Lewis RJ (2000) Video-assisted thoracic surgery as a diagnostic tool. In: Shields TW, LoCicero J, Ponn RB (eds): General Thoracic Surgery, 5th Edition. Philadelphia, Lippincott, Williams & Wilkins. pp. 285–293

    Google Scholar 

  10. 10.

    Cardillo G, Regal M, Sera F, Di Martino M, Carbone L, Facciolo F, Martelli M (2003) Videothoracoscopic management of the solitary pulmonary nodule: a single-institution study on 429 cases. Ann Thorac Surg 75:1607–1612

    Article  PubMed  Google Scholar 

  11. 11.

    Chang AC, Yee J, Orringer MB, Iannettoni MD (2002) Diagnostic thoracoscopic lung biopsy: an outpatient experience. Ann Thorac Surg 74:1942–1947

    Article  PubMed  Google Scholar 

  12. 12.

    Conlan AA, Sandor A (2003) Total thoracoscopic pneumonectomy: indications and technical considerations. J Thorac Cardiovasc Surg 126:2083–2085

    Article  PubMed  Google Scholar 

  13. 13.

    Corinna L, Passlick B, Stoelben E (2005) Recurrent hamartoma at the trocar incision site after video-assisted thoracic surgical resection. J Thorac Cardiovasc Surg 130:609–610

    Article  Google Scholar 

  14. 14.

    Craig SR, Walker WS (1995) Initial experience of video-assisted thoracoscopic pneumonectomy. Thorax 50:392–395

    Article  CAS  PubMed  Google Scholar 

  15. 15.

    DeCamp MM, Blackstone EH, Naunheim KS, Krasna MJ, Wood DE, Meli YM, McKenna RJ Jr, for the NETT Research Group (2006) Patient and surgical factors influencing air leak after lung volume reduction surgery: lessons learned from the National Emphysema Treatment Trial. Ann Thorac Surg 82:197–207

    Article  PubMed  Google Scholar 

  16. 16.

    DeCamp MM Jr, Jaklitsch MT, Mentzer SJ, Harpole DH, Sugarbaker DJ (1995) The safety and versatility of video-thoracoscopy: a prospective analysis of 895 consecutive cases. J Am Coll Surg 181:113–120

    PubMed  Google Scholar 

  17. 17.

    Dendo S, Kanazawa S, Ando A, Hyodo T, Kouno Y, Yasui K, Mimura H, Akaki S, Kuroda M, Shimizu N, Hiraki Y (2002) Preoperative localization of small pulmonay lesions with a short hook wire and suture system: experience with 168 procedures. Radiology 225:511–518

    Article  PubMed  Google Scholar 

  18. 18.

    Downey RJ (1998) Complications after video-assisted thoracic surgery. Chest Surg Clin North Am 8:907–917

    CAS  Google Scholar 

  19. 19.

    Downey RJ, McCormack P, LoCicero J 3rd (1996) Dissemination of malignant tumors after video-assisted thoracic surgery: a report of twenty-one cases. The video-assisted thoracic study group. J Thorac Cardiovasc Surg 111:954–960

    Article  CAS  PubMed  Google Scholar 

  20. 20.

    Eichfeld U, Dietrich A, Ott R, Kloeppel R (2005) Video-assisted thoracoscopic surgery for pulmonary nodules after computed tomography-guided marking with a spiral wire. Ann Thorac Surg 79:313–316

    Article  PubMed  Google Scholar 

  21. 21.

    Fry WA, Siddiqui A, Pensler JM, Mostafavi H (1995) Thoracoscopic implantation of cancer with a fatal outcome. Ann Thorac Surg 59:42–45

    Article  CAS  PubMed  Google Scholar 

  22. 22.

    Geiser T, Schwizer B, Krueger T, Gugger M, Hof VI, Dusmet M, Fitting JM, Ris HB (2001) Outcome after unilateral lung volume reduction surgery in patients with severe emphysema. Eur J Cardio-thorac Surg 20:674–678

    Article  CAS  Google Scholar 

  23. 23.

    Gharagozloo F, Tempesta B, Margolis M, Alexander EP (2003) Video-assisted thoracic surgery lobectomy for stage I ling cancer. Ann Thorac Surg 76:1009–1015

    Article  PubMed  Google Scholar 

  24. 24.

    Gossot D, de Kervieler E, Paladines G, Frija J, Celerier M (1997) Thoracoscopic approach in pulmonary nodules: a prospective evaluation of a series of 120 patients. Rev Mal Respir 14:287–293

    CAS  PubMed  Google Scholar 

  25. 25.

    Hazelrigg SR, Boley TM, Magee MJ, Lawyer CH, Henkle JQ (1998) Comparison of staged thoracoscopy and median sternotomy for lung volume reduction. Ann Thorac Surg 66:1134–1139

    Article  CAS  PubMed  Google Scholar 

  26. 26.

    Hazelrigg SR, Nunchuck SK, LoCicero J and the Video Assisted Thoracic Surgery Study Group (1993) Video-assisted thoracic surgery study group data. Ann Thorac Surg 56:1039–1044

    Article  CAS  PubMed  Google Scholar 

  27. 27.

    Inderbitzi RGC, Grillet MP (1996) Risk and hazards of video-thoracoscopic surgery: a collective review. Eur J Cardio-thorac Surg 10:483–489

    Article  CAS  Google Scholar 

  28. 28.

    Iwasaki A, Shirakusa T, Shiraishi T, Yamamoto S (2004) Results of video-assisted thoracic surgery for stage I/II non-small cell lung cancer. Eur J Cardio-thorac Surg 26:158–164

    Article  Google Scholar 

  29. 29.

    Jancovici R, Lang-Lazdunski L, Pons F, Cador L, Dujon A, Dahan M, Azorin J (1996) Complications of video-assisted thoracic surgery: a five-year experience. Ann Thorac Surg 61:533–537

    Article  CAS  PubMed  Google Scholar 

  30. 30.

    Jimenez MJ, the Spanish video-assisted thoracic surgery study group (2001) Prospective study on video-assisted thoracoscopic surgery in the resection of pulmonary nodules: 209 cases from the Spanish video-assisted thoracic surgery study group. Eur J Cardio-thorac Surg 19:562–565

    Article  CAS  Google Scholar 

  31. 31.

    Kaseda S, Aoki T, Hangai N (1998) Video-assisted thoracic surgery (VATS) lobectomy: the Japanese experience. Semin Thorac Cardiovasc Surg 10:300–304

    CAS  PubMed  Google Scholar 

  32. 32.

    Keenan RJ, Landreneau RJ, Sciurba FC, Ferson PF, Holbert JM, Brown ML, Fetterman LS, Bowers CM (1996) Unilateral thoracoscopic surgical approach for diffuse emphysema. J Thorac Cardiovasc Surg 111:308–316

    Article  CAS  PubMed  Google Scholar 

  33. 33.

    Kerrigan DC, Spence PA, Crittenden MD, Tripp MD (1992) Methylene blue guidance for simplified resection of a lung lesion. Ann Thorac Surg 53:163–164

    CAS  PubMed  Article  Google Scholar 

  34. 34.

    Kirby TJ, Rice TW (1993) Thoracoscopic lobectomy. Ann Thorac Surg 56:784–786

    CAS  PubMed  Article  Google Scholar 

  35. 35.

    Krasna MJ, Deshmukh S, McLaughlin JS (1996) Complications of thoracoscopy. Ann Thorac Surg 61:1066–1069

    Article  CAS  PubMed  Google Scholar 

  36. 36.

    Lacronique J, Kleinmann P, Levi JF, Carnot F, Debesse B (1991) Exérèse d’un nodule sous-pleural par video-chirurgie percutanée. Rev Pneumol Clin 47:229–231

    CAS  PubMed  Google Scholar 

  37. 37.

    Landreneau RJ, Herlan DB, Johnson JA, Boley TM, Nawarawong W, Ferson PF (1991) Thoracoscopic neodymium: yttrium-aluminium laser-assisted pulmonary resection. Ann Surg 52:1176–1178

    CAS  Google Scholar 

  38. 38.

    Landreneau RJ, Mack MJ, Hazelrigg SR, Naunheim K, Dowling RD, Ritter P, Magee MJ, Nunchuck S, Keenan RJ, Ferson PF (1994) Prevalence of chronic pain following pulmonary resection by thoracotomy or video-assisted thoracic surgery. J Thorac Cardiovasc Surg 107:1079–1086

    CAS  PubMed  Google Scholar 

  39. 39.

    Landreneau RJ, Wiechmann RJ, Hazelrigg SR, Mack MJ, Keenan RJ, Ferson PF (1998) Effect of minimally invasive thoracic surgical approaches on acute and chronic postoperative pain. Chest Surg Clin North Am 8:891–906

    CAS  Google Scholar 

  40. 40.

    Levi JF, Kleinmann P, Riquet M, Debesse B (1990) Percutaneous parietal pleurectomy for recurrent spontaneous pneuothorax. Lancet 336:1577–1578

    Article  CAS  PubMed  Google Scholar 

  41. 41.

    Lewis RJ, Caccavale RJ, Sisler GE, Bocage JP, Mackenzie JW (1997) One hundred video-assisted thoracic surgical simultaneously stapled lobectomies without rib spreading. Ann Thorac Surg 63:1415–1422

    Article  CAS  PubMed  Google Scholar 

  42. 42.

    Lewis RJ, Caccavale RJ, Sisler GE, Mackenzie JW (1992) One hundred consecutive patients undergoing video-assisted thoracic operations. Ann Thorac Surg 54:421–426

    CAS  PubMed  Article  Google Scholar 

  43. 43.

    Lewis RJ, Sisler GE, Caccavale RJ (1992) Imaged thoracic lobectomy: should it be done? Ann Thorac Surg 54:80–83

    CAS  PubMed  Article  Google Scholar 

  44. 44.

    Loscertales J, Jimenez-Merchan R, Arenas-Linares C, Giron-Arjona JC, Congregado-Loscertales M (1997) The use of video-assisted thoracic surgery in lung cancer: evaluation of resectability in 296 patients and 71 pulmonary exeresis with radical lymphadenectomy. Eur J Cardio-thorac Surg 12:892–897

    Article  CAS  Google Scholar 

  45. 45.

    Mack MJ, Hazelrigg SR, Landreneau RJ, Acuff TE (1993) Thoracoscopy for the diagnosis of the indeterminate solitary pulmonary nodule. Ann Thorac Surg 56:825–832

    CAS  PubMed  Article  Google Scholar 

  46. 46.

    Mack MJ, Shennib H, Landreneau RJ, Hazelrigg SR (1993) Techniques for localization of pulmonary nodules for thoracoscopic resection. J Thorac Cardiovasc Surg 106:550–553

    CAS  PubMed  Google Scholar 

  47. 47.

    Marasugi M, Onuki T, Ikeda T, Kanzaki M, Nitta S (2001) The role of video-assisted thoracoscopic surgery in the diagnosis of the small peripheral pulmonary nodule. Surg Endosc 15:734–736

    Article  Google Scholar 

  48. 48.

    Maziak DE, McKneally MF (1995) Video-assisted thoracic surgery. Ann Thorac Surg 59:780–781

    Article  CAS  PubMed  Google Scholar 

  49. 49.

    McKenna RJ Jr, Brenner M, Fischel RJ, Gelb AF (1996) Should lung volume reduction for emphysema be unilateral or bilateral? J Thorac Cardiovasc Surg 112:1331–1339

    Article  PubMed  Google Scholar 

  50. 50.

    McKenna RJ Jr, Brenner M, Gelb AF, Mullin M, Singh N, Peters H, Panzera J, Calmese J, Schein MJ (1996) A randomized prospective trial of stapled lung reduction versus laser bullectomy for diffuse emphysema. J Thorac Cardiovasc Surg 111:317–322

    Article  PubMed  Google Scholar 

  51. 51.

    McKenna RJ Jr, Houck W, Beeman Fuller C (2006) Video-assisted thoracic lobectomy: experience with 1100 cases. Ann Thorac Surg 81:421–426

    Article  PubMed  Google Scholar 

  52. 52.

    Nathanson LK, Shimi SM, Wood RAB, Cuschieri A (1991) Videothoracoscopic ligation of bulla and pleurectomy for spontaneous pneumothorax. Ann Thorac Surg 52:316–319

    CAS  PubMed  Article  Google Scholar 

  53. 53.

    Naunheim KS, Keller CA, Krucylak PE, Singh A, Ruppel G, Osteroh JF (1996) Unilateral video-assisted surgical lung reduction. Ann Thorac Surg 61:1092–1098

    Article  CAS  PubMed  Google Scholar 

  54. 54.

    Nomori H, Horio H (1996) Colored collagen is a long-lasting point marker for small pulmonary nodules in thoracoscopic operations. Ann Thorac Surg 61:1070–1073

    Article  CAS  PubMed  Google Scholar 

  55. 55.

    Nwogu CE, Glinianski M, Demmy TL (2006) Minimally invasive pneumonectomy. Ann Thorac Surg 82:e3–4

    Article  PubMed  Google Scholar 

  56. 56.

    Oey IF, Morgan MDL, Waller DA (2003) Postoperative pain detracts from early health status improvement seen after video-assisted thoracoscopic lung volume reduction surgery. Eur J Cardio-thorac Surg 24:588–593

    Article  CAS  Google Scholar 

  57. 57.

    Ohtsuka T, Nomori H, Horio H, Naruke T, Suemasu K (2004) Is major pulmonary resection by video-assisted thoracic surgery an adequate procedure in clinical stage I lung cancer? Chest 125:1742–1746

    Article  PubMed  Google Scholar 

  58. 58.

    Onaitis MW, Petersen RP, Balderson SS, Toloza E, Burfeind WR, Harpole DH, D’Amico TA (2006) Thoracoscopic lobectomy is a safe and versatile procedure. Experience with 500 consecutive patients. Ann Surg 244:420–425

    PubMed  Google Scholar 

  59. 59.

    Ooi A, Iyenger S, Ferguson J, Ritchie AJ (2005) VATS lung biopsy in suspected, diffuse interstitial lung disease provides diagnosis, and alters management strategies. Heart Lung Circ 14:90–92

    Article  PubMed  Google Scholar 

  60. 60.

    Parekh K, Rusch V, Bains M, Downey R, Ginsberg R (2001) VATS port site recurrence: a technique dependent problem. Ann Surg Oncol 8:175–178

    Article  CAS  PubMed  Google Scholar 

  61. 61.

    Peillon C, Testart J (1991) Surgical thoracoscopy. Presse Med 20:125–1217

    Google Scholar 

  62. 62.

    Plunkett MB, Peterson MS, Landreneau RJ, Ferson PF, Posner MC (1992) Peripheral pulmonary nodules: preoperative percutaneous needle localisation with CT guidance. Radiology 185:274–276

    CAS  PubMed  Google Scholar 

  63. 63.

    Rena O, Casadio C, Leo F, Giobbe R, Cianci R, Baldi S, Rapellino M, Maggi G (1999) Videothoracoscopic lung biopsy in the diagnosis of interstitial lung disease. Eur J Cardio-thorac Surg 16:624–627

    Article  CAS  Google Scholar 

  64. 64.

    Riley DJ, Costanzo EJ (2006) Surgical biopsy: its appropriateness in diagnosing interstitial lung disease. Curr Opin Pulm Med 12:331–336

    Article  PubMed  Google Scholar 

  65. 65.

    Roviaro G, Varoli F, Rebuffat C, Vergani C, D’Hoore A, Maciocco M, Grignani F (1993) Major pulmonary resections: pneumonectomies and lobectomies. Ann Thorac Surg 56:779–783

    CAS  PubMed  Article  Google Scholar 

  66. 66.

    Roviaro G, Varoli F, Vergani C, Maciocco M (1999) Technique of pneumonectomy. Video-assisted thoracic surgery pneumonectomy. Chest Surg Clin North Am 9:419–436

    CAS  Google Scholar 

  67. 67.

    Roviaro G, Varoli F, Vergani C, Maciocco M (2002) State of the art in thoracoscopic surgery. A personal experience of 2000 videothoracoscopic procedures and an overview of the literature. Surg Endosc 16:881–892

    Article  CAS  PubMed  Google Scholar 

  68. 68.

    Roviaro G, Varoli F, Vergani C, Maciocco M, Nucca O, Pagano C (2004) Video-assisted thoracoscopic major pulmonary resections: technical aspects, personal series of 259 patients, and review of the literature. Surg Endosc 18:1551–1558

    CAS  PubMed  Google Scholar 

  69. 69.

    Sasaki M, Hirai S, Kawabe M, Ueseka T, Morioka K, Ihaya A, Tanaka K (2005) Triangle target principle for the placement of trocars during video-assisted thoracic surgery. Eur J Cardio-thorac Surg 27:307–312

    Article  Google Scholar 

  70. 70.

    Shennib HAF, Landreneau R, Mulder DS, Mack M (1993) Video-assisted thoracoscopic wedge resection of T1 lung cancer in high-risk patients. Ann Surg 218:555–560

    Article  CAS  PubMed  Google Scholar 

  71. 71.

    Shigemura N, Akashi A, Nakagiri T, Ohta M, Matsuda H (2004) Complete vs assisted thoracoscopic approach. A prospective randomized trial comparing a variety of video-assisted thoracoscopic techniques. Surg Endosc 18:1492–1497

    Article  CAS  PubMed  Google Scholar 

  72. 72.

    Shirashi T, Shirakusa T, Iwasaki A, Hiratsuka M, Yamamoto S, Kawahara K (2004) Video-assisted thoracoscopic surgery (VATS) segmentectomy for small peripheral lung cancer tumors: intermediate results. Surg Endosc 18:1657–1662

    Google Scholar 

  73. 73.

    Solaini L, Bagioni P, Grandi U (1995) Role of videoendoscopy in pulmonary surgery: present experience. Eur J Cardio-thorac Surg 9:65–68

    Article  CAS  Google Scholar 

  74. 74.

    Solaini L, Bagioni P, Prusciano F, Di Francesco F, Poddie DB (2000) Video-assisted thoracic surgery (VATS) lobectomy for typical bronchopulmonary carcinoid tumors. Surg Endosc 14:1142–1145

    Article  CAS  PubMed  Google Scholar 

  75. 75.

    Solaini L, Prusciano F, Bagioni P, Di Francesco F, Poddie DB (2001) Video-assisted thoracic major pulmonary resections. Present experience. Eur J Cardio-thorac Surg 20:437–442

    Article  CAS  Google Scholar 

  76. 76.

    Solaini L, Prusciano F, Bagioni P, Poddie DB (2004) Long-term results of video-assisted thoracic surgery lobectomy for stage I non-small cell lung cancer: a single-centre study of 104 cases. Interact CardioVasc Thorac Surg 3:57–62

    Article  CAS  PubMed  Google Scholar 

  77. 77.

    Son SY, Saidi G, Ong MLH, Syed A, Codispoti M, Walker WS (2003) Sequential VATS lung volume reduction surgery: prolongation of benefits derived after the initial operation. Eur J Cardio-thorac Surg 24:149–153

    Article  Google Scholar 

  78. 78.

    Stammberger U, Thurnheer R, Bloch KE, Zollinger A, Schmid RA, Russi EW, Weder W (1997) Thoracoscopic bilateral lung volume reduction for diffuse pulmonary emphysema. Eur J Cardio-thorac Surg 11:1005–1010

    Article  CAS  Google Scholar 

  79. 79.

    Stoica SC, Craig SR, Soon SY, Walker WS (2002) Spontaneous rupture of the right hemidiaphragm after video-assisted lung volume reduction surgery. Ann Thorac Surg 74:929–931

    Article  PubMed  Google Scholar 

  80. 80.

    Temes RT, Talbot WA, Green DP, Wernly JA (2001) herniation of the lung after video-assisted thoracic surgery. Ann Thorac Surg 72:606–607

    Article  CAS  PubMed  Google Scholar 

  81. 81.

    Thomas P, Doddoli C, Yena S, Thirion X, Sebag F, Fuents P, Giudicelli R (2002) VATS is an adequate oncological operation for stage I non-small cell lung cancer. Eur J Cardio-thorac Surg 21:1094–1099

    Article  CAS  Google Scholar 

  82. 82.

    Thurer RL (1993) Video-assisted thoracic surgery. Ann Thorac Surg 56:199–200

    CAS  PubMed  Article  Google Scholar 

  83. 83.

    Walker WS (1998) Video-assisted thoracic surgery (VATS) lobectomy: the Edinburgh experience. Semin Thorac Cardiovasc Surg 10:291–299

    CAS  PubMed  Google Scholar 

  84. 84.

    Walker WS, Carnochan FM, Pugh GC (1993) Thoracoscopic pulmonary lobectomy: early operative experience and preliminary clinical results. J Thorac Cardiovasc Surg 106:1111–1117

    CAS  PubMed  Google Scholar 

  85. 85.

    Walker WS, Codispoti M, Soon SY, Stamenkovic S, Carnochan F, Pugh G (2003) Long-term outcomes following VATS lobectomy for non-small cell bronchogenic carcinoma. Eur J Cardio-thorac Surg 23:397–402

    Article  Google Scholar 

  86. 86.

    Watanabe A, Watanabe T, Ohsawa H, Mawatari T, Ichimiya Y, Takahashi N, Sato H, Abe T (2004) Avoiding chest tube placement after video-assisted thoracoscopic wedge resection of the lung. Eur J Cardio-thorac Surg 25:872–876

    Article  Google Scholar 

  87. 87.

    Wicky S, Mayor B, Cuttat JF, Schneider P (1994) CT-guided localisation of pulmonary nodules with methylene blue injections for thoracoscopic resections. Chest 106:1326–1328

    Article  CAS  PubMed  Google Scholar 

  88. 88.

    Yamaguchi M, Yoshino I, Suemitsu R, Osoegawa A, Kameyama T, Tagawa T, Fukuyama S, Maehara Y (2004) Elective video-assisted thoracoscopic lung biopsy for interstitial lung disease. Asian Cardiovasc Thorac Ann 12:65–68

    PubMed  Google Scholar 

  89. 89.

    Yim APC, Izzat MB, Liu HP, Ma CC (1998) Thoracoscopic major lung resections: an Asian perspective. Semin Thorac Cardiovasc Surg 10:326–331

    CAS  PubMed  Google Scholar 

  90. 90.

    Yim APC, Ko K, Chau W, Ma C, Ho JKS, Kyaw K (1996) Video-assisted thoracoscopic anatomic lung resections. The initial Hong Kong experience. Chest 109:13–17

    Article  CAS  PubMed  Google Scholar 

  91. 91.

    Yim APC, Landreneau RJ, Izzat MB, Fung ALK (1998) Is video-assisted thoracoscopic lobectomy a unified approach? Ann Thorac Surg 66:1155–1158

    Article  CAS  PubMed  Google Scholar 

  92. 92.

    Yim APC, Liu HP (1996) Complications and failures of video-assisted thoracic surgery: experience of two centers in Asia. Ann Thorac Surg 61:538–541

    Article  CAS  PubMed  Google Scholar 

  93. 93.

    Zegdi R, Azorin J, Tremblay B, Destable MD, Lajos PS, Valeyre D (1998) Videothoracoscopic lung biopsy in diffuse infiltrative lung diseases: a 5-year surgical experience. Ann Thorac Surg 66:1170–1173

    Article  CAS  PubMed  Google Scholar 

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Solaini, L., Prusciano, F., Bagioni, P. et al. Video-assisted thoracic surgery (VATS) of the lung. Surg Endosc 22, 298–310 (2008). https://doi.org/10.1007/s00464-007-9586-0

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Keywords

  • Video-assisted thoracic surgery
  • Pulmonary surgery
  • Intraoperative complications
  • Postoperative complications
  • Surgical biopsy
  • Wedge resection
  • Lobectomy
  • Pneumonectomy