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Ann Thorac Surg 1996;61:533-537
© 1996 The Society of Thoracic Surgeons

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Original Article: General Thoracic

Complications of Video-Assisted Thoracic Surgery: A Five-Year Experience

Departments of Thoracic Surgery, Hôpital du Val de Grâce, Paris; Clinique du Cèdre, Rouen; Hôpital Purpan, Toulouse; and Hôpital Avicenne, Bobigny, France

Accepted for publication October 23, 1995.

Background. Although thoracoscopy was originally described in 1910, recent developments in video-assisted surgical techniques and endoscopic equipment has expanded the application of video-assisted surgical procedures in the field of thoracic surgery.

Methods. In an effort to define both high-risk patients for video-assisted thoracic procedures and high-risk video-assisted thoracic surgical procedures, we reviewed the experience of four surgical institutions from June 1991 through May 1995. We looked specifically at complications resulting from the 937 video-assisted thoracic procedures performed during this period.

Results. Perioperative incidents or complications occurred in 35 patients (3.7%), and 116 procedures (12.4%) were converted to a thoracotomy. The in-hospital mortality rate was 0.5%, and death occurred principally in patients operated on for malignant pleural effusion. The overall incidence of postoperative complications was 10.9%, and the most prevalent complications were prolonged air leak (6.7%) and pleural effusion (0.7%).

Conclusions. The incidence of complications was acceptable and, except for that of prolonged air leak, did not differ significantly from that resulting from analogous open procedures. Video-assisted thoracic surgery appears safe and particularly useful for some indications. However, the possibility of dramatic life-threatening perioperative complications requiring emergency conversion to thoracotomy justifies the fact that only trained thoracic surgeons should perform video-assisted thoracic surgical procedures.

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