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  • Title: Video-assisted thoracic surgery. Staging and management of thoracic tumors.
    Author: Rau B, Hünerbein M, Below C, Schlag PM.
    Journal: Surg Endosc; 1998 Feb; 12(2):133-6. PubMed ID: 9479727.
    Abstract:
    BACKGROUND: This prospective study was conducted to investigate the value of video-assisted thoracic surgery (VATS) for staging and therapy of thoracic tumors. METHODS: VATS was performed in 86 patients presenting peripheral pulmonary nodules. Indications for thoracoscopy included diagnosis of indeterminated pulmonary lesions (n = 55), staging of disseminated disease (n = 24), and therapeutic interventions (n = 7). Previous or simultaneous tumors belonged to gastrointestinal tract (n = 27), sarcoma (n = 19), breast (n = 12), and miscellaneous. VATS was carried out under general anesthesia using double lumen intubation. RESULTS: VATS was successfully performed in 78% of patients. It was converted in 19 patients (22%) because of adhesions (n = 12), technical problems (n = 3), and lesions not to be found (n = 4). VATS revealed malignancy in 81% and benign lesions in 19%. Additional information compared to conventional staging was obtained in 48%, resulting in therapeutic consequences in 34% of the patients. Postoperative complications related to VATS were observed in nine patients. CONCLUSIONS: In this study, VATS proved to be a sensitive technique for staging of pulmonary lesions. Thoracoscopic wedge resection may have significant impact on the operative management of carefully selected patients with peripheral pulmonary lesions.
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