Prevention of complications of video-assisted thoracoscopic surgery / 中华胸心血管外科杂志

ABSTRACT

Objective To retrieval the ways of prevent complications of video-assisted thoracoscopic surgery. Methods The operation included bullectomy in 462 patients, resection of mediastinal tumor or cyst in 86; esophageal diseases in 94, lobectomy or wedge resection of lung in 140, VATS hemostasis in 22, partial pericardial or pleural excision in 54 and biopsy for undetermined chest diseases in 54. Combined anesthesia with intubations of double lumen tracheal tube was performed in 866 patients and single-lumen tracheal tube in 46. Results 886 operations were completed by VATS, and 26cases were converted into thoracotomy for various reasons. Complications occurred in 36 patients (3.95%), including 10 cases occurred during the operation (esophageous mucous rupture in 4, nerve injury in 2 and insufficient hemostasis leading to postoperative bleeding in 4). 26 cases (2.85%) developed complications postoperatively, including persistent air leak (≥7 days) in 19, pleural effusion making a second water-sealed drainage necessary in 3, atrial fibrillation in 2 and infection in 1. One died for respiratory failure on the fifth postoperative day. Conclusion VATS experience should be gained systematically. In order to reduce the complications, more attentions must be paid to training of the thoracic surgeons in order to master the skill and the correlated knowledge of VATS.