Major pulmonary resection by video assisted mini-thoracotomy. Initialexperience in 35 patients

Video-assisted thoracic surgery is emerging as a viable approach toincreasingly complex intrathoracic therapeutic procedures. From February toJuly 1993, 35 patients (25 male, 10 female; mean age = 60 years, range:17-74) underwent a major pulmonary resection using a video-assistedtechnique: lobectomy (n = 30) or pneumonectomy (n = 5). Pathology disclosedbronchogenic carcinomas (n = 26), metastases (n = 3), and miscellaneousdisorders (n = 6). All procedures required one 10.5 mm port for thevideo-camera, one 3.5 to 5 cm utility thoracotomy through which surgicalinstrumentation was inserted and the operative specimen removed, and oneoccasional supplementary 12 mm port. Lung resections were performed withseparated dissection and division of each component of the pedicle. Themean operative time was 145 min (SD: +/- 17). There were two postoperativedeaths (5.7%) that were not directly related to the technique. Sevenpatients (20%) experienced non- fatal complications. After lobectomy, themean duration of chest tube placement was 7.3 days (SD: +/- 1.6). The meanhospital stay was 11 days (SD: +/- 3). All the patients experienced minorpostoperative chest pain. We conclude that video-assisted lung resectionsare technically feasible without an increased risk.