All patients who underwent video-assisted thoracic surgery(VATS) for diagnostic purposes from Jan. 1992 to Aug. 1995 were reviewed. The total number of patients were III with 57 male and 54 female, and the mean age was 49 years(range 1 to 74).
Multiple
biopsies from more than one location were performed in 17 patients; pleural biopsies were performed in 49 patients, lung biopsies in 43 patients, mediastinal mass or lymph node biopsies in 33 patients, and two pericardium biopsieds and one
diaphragm
biopsy, for a total of 128 biopsies. Seventeen pleural biopsy cases and one lung biopsy case underwent operation under local anesthesia; the rest were performed under general anesthesia.
In patients who underwent lung biopsy, the age was 49.1 years(range 22~). The operating time was 40 to 170 minutes(mean 97), intravenous or intramuscular injection for pain control was required 0 to 22 times(mean 4.7), and chest tube was inserted
from 1
to 26 days(mean 7). In all patients except two, a diagnosis was obtained from the biopsy and complication was encountered in one patient in whom intraoperative paroxysmal atrial tachycardia was detected. In 7 patients, a thoracotomy had to be
done
due
to pleural adhesion or intraoperative bleeding, and 7 patients had postoperative complications associated with the chest tube.
In the pleural biopsy group, the mean age was 49 years(range 17~74). The operating time was 25 to 80 minutes(mean 49), intravenous or intramuscular injection for pain control was needed to 0 to 20 times (mean 3.6), and the chest tube was inserted
for 0
t 67 days(mean 9.8). In all the patients, a diagnosis was possible. The chest tube was inserted for longer than 7 days in 11 patients.
In the lymph node biopsy group, the mean age was 44.2 years(range 1~68). The operating time was 30 to 335 minutes(mean 105), pain control was required 0 to 15 times(mean 3.2), and a chest tube was kept in place for 1 to 36 days(mean 6.1). In one
patient, a diagnosis was not possible and chest tube was kept in place for lcnger than 7 days in 7 patients.
In the multiple biopsy group, the mean age was 53.1 years(range 20~71). The operating time was 15 to 165 minutes(mean 85), and pain control was done from 0 to 17 times(mean 3.1). the chest tube was kept in place for 1 to 16 days(mean 7.9).
VATS in a relatively simple, safe diagnostic method with a high diagnostic yield, and it also helps to avoid unnecessary thoracotomies in selected patients.
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