Technical problems and complications in major videoendoscopic pulmonary resections

The progress in video-technology and the development of endoscopic instrumentation, particularly endostapling devices, has enhanced the application of the minimally invasive appmach in thoracic surgery. Fmm October '91 to April '94, 389 thoracoscopic procedures were performed in ou rDepartment of General Surgery: in this group 74 major pulmonary resections were carried out The series included 5 pneumonectomies and 69 lobectomies. The criteria for major videothoracoscopic pulmonary operations were 1) benign pulmonary diseases 2) pulmonary metastases not removable by wedge resection 3) primary lung cancer at Stage I. 81 pts. underwent thorawscopic surgery with the intent to .perform a major pullnonary resection, but 7 pts. required conversion to thoracotomy, for absent fissure and for bleeding. In patients with lung cancer an accurate Iymphoadenectomy can be performed. 65 patients (88%) had short post-operative wurse, without any problem. Nine patients had pmlonged air leakage and one of them was also wrnplicated by bronchial fistula. No intra-operative or post-operative deaths.