Role of videoendoscopy in pulmonary surgery: present experience.

Videothoracoscopic techniques were utilized in managing 88 consecutive patients. The series was composed of 36 patients with pneumothorax, 44 cases of single and 9 of multiple pulmonary nodules and 1 patient with diffuse lung disease. In 14 cases (15.9%) conversion to open thoracotomy was necessary while in the remaining 74 patients the procedure (30 blebectomies, 2 bullectomies, 37 wedge resections, 6 lobectomies and one multiple biopsies) were carried out as planned. In each lobectomy and in six wedge resections an accessory small incision was necessary; we consider only this video-assisted thoracic surgery (VATS). Benign disease, aside from the blebs and bullae, was found in 12 cases of solitary pulmonary nodules and in I case of multiple lesions, while malignant lesions were detected in 31 patients. Primary carcinoma was diagnosed in nine cases after a wedge resection had been performed on a suspicious solitary nodule. In two of these wedge resection had to suffice because of poor lung function, while in the remaining seven cases, a lobectomy was carried out through an open thoracotomy in two patients, and in five cases VATS was attempted successfully in four, while in one case a formal thoracotomy was necessary due to bleeding. Solitary metastases were found in 14 patients and were managed by 12 wedge resections and 2 lobectomies. Seventy-one patients (97.3%) had an uneventful postoperative course while 2 (2.7%) had only minor complications. No recurrences were observed, however follow-up is limited. Videothoracoscopy techniques are very useful and are good alternatives to conventional thoracotomy in managing cases of pneumothorax, benign pulmonary lesions and in taking biopsies. Further evaluation is necessary in cases of stage I primary lung cancer and in certain cases of solitary metastasis, however the initial results of videothoracoscopy seem to be favorable