A Preferred approach in diagnosis and treatment: VATS

Amaç: VATS (Video Yardımlı Göğüs Cerrahisi) göğüs cerrahisi işlemlerinde, plevral biyopsi, akciğer rezeksiyonları gibi değişik endikasyonlar ile yaygın olarak kullanılmaktadır. Kliniğimizde çeşitli hastalıklarda VATS uygulanılan cerrahiler gözden geçirildi. Yöntemler: Mayıs 2009-Mart 2011 tarihleri arasında VATS uygulanılan 45 hastanın kayıtları retrospektif olarak değerlendirildi. Hastaların 21i erkek, 24ü kadın idi. Yaşları 15-72 arasında değişmekteydi (ortalama yaş 53.5). Bulgular: Kırk beş hastaya 51 operasyon yapıldı. Plevral efüzyon ve/veya plevral kalınlaşma nedeniyle 23, akciğerde nodül veya kitle nedeniyle 13, pnömotoraks veya uzamış hava kaçağı nedeniyle 4, hiperhidrozis ve sempatik hiperaktivite nedeniyle 5 olguya VATS yapıldı. Plevral efüzyonu olan hastaların 16sında malign, 7sinde ise benign patoloji saptandı. Pulmoner nodülü olan 9 hastada patoloji benign, 4 hastada ise malign olarak raporlandı. Pnömotoraks nedeniyle wedge rezeksiyon yapılan bir hastada uzamış hava kaçağı oldu ve tekrar opere edildi. Mortalite bir hastada görüldü. Sonuç: VATS göğüs cerrahisi pratiğinde tanısal ve tedavi amaçlı kullanılmaktadır. VATS uygun hastalarda tercih edilebilecek bir yöntemdir. (Gazi Med J 2012; 23: 10-2)

Tanı ve tedavide tercih edilen yöntem: VATS

Objective: VATS (video-assisted thoracic surgery) is commonly used for variable indications in thoracic surgery procedures such as pleural biopsy and lung resections. The use of VATS in our clinic for various diseases was reviewed. Methods: The files of 45 patients that underwent VATS were assessed retrospectively between May 2009 and March 2011. Cases consisted of 21 males and 24 females; the age range was 15 to 72 years and the mean age was 53.5 years. Results: Fifty-one operations were performed on the 45 cases. A total of six cases, including five cases of hyperhidrosis and one case of pleural effusion, underwent simultaneous bilateral operations. VATS was performed for pleural effusion and/or pleural thickening in 23 cases, for a lung nodule or lung mass in 13, for pneumothorax and prolonged air leak in four, and for hyperhidrosis-sympathetic hyperactivity in five cases. The pathological analyses of 16 patients with pleural effusion indicated malignant disease while seven patients had benign findings. Nine of the patients with pulmonary nodules were reported as benign while four were reported as malignant by pathology. In one patient who underwent wedge resection for pneumothorax, prolonged air leakage occurred and the patient underwent reoperation. Death occurred in one patient. Conclusion: VATS is used for diagnostic and therapeutic purposes in the practice of thoracic surgery. It is the preferred method for selected patients. (Gazi Med J 2012; 23: 10-2)

___

  • Medford AR, Awan YM, Marchbank A, Rahamim J, Unsworth white C, Pearson PJ. Diagnostic and therapeutic performance of video-assisted thoracoscopic surgery (VATS) in investigation and management of pleural exudates. Ann R Coll Surg Engl 2008; 90: 597-600.
  • Yim AP, Lee TW, Izzat MB, Wan S. Place of video-thoracoscopy in thoracic surgical practice. World J Surg 2001; 25: 157-61.
  • Boutin C, Rey F. Thoracoscopy in pleural mesothelioma: a prospective study of 188 consecutive patients. Cancer 1993; 72: 389-93.
  • Kürkcüoğlu C, Karaoğlanoğlu N, Eroğlu A, Unlü M. Videothoracoscopy for pleural effusion: A Review of 47 cases. Turkısh J Thoracic and Cardio- vasc Surg 2000; 8: 712-4.
  • LoCicero J 3rd. Thoracoscopic management of malignant pleural effusion. Ann Thorac Surg 1993; 56: 641-3.
  • Daniel TM. Diagnostic thoracoscopy for pleural disease. Ann Thorac Surg 1993; 56: 639-40.
  • Shaikrezai K, Thompson AI, Parkin C, Stamenkovic S, Walker WS. Video-assisted thoracoscopic surgery management of spontaneous pneumothorax - long-term results. Eur J Cardiothorac Surg 2011; 40: 120-3.
  • Deng B, Tan QY, Jiang YG, Zhao YP, Zhou JH, Ma Z, et al. Optimization of sympathectomy to treat palmar hyperhidrosis: the systematic review and meta-analysis of studies published during the past decade. Surg Endosc 2011; 25: 1893-901.
Gazi Medical Journal-Cover
  • Yayın Aralığı: Yılda 4 Sayı
  • Yayıncı: Gazi Üniversitesi Tıp Fakültesi