Minimally invasive thoracic surgery: where do we stand now?

APC Yim, JKS Ho, V Abdullah
Cardiothoracic Unit, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong

Video-assisted thoracoscopic surgery and interventional bronchoscopy represent different aspects of minimally invasive thoracic surgery. From September 1992 to February 1994, we successfully performed a total of 284 thoracoscopic procedures on 192 patients which consisted of 79 bleb eliminations and 105 mechanical pleurodesis; 26 wedge resections; eight wedge biopsies; six thoracic sympathectomies; six mediastinal mass resections; six pericardial windows; 16 guided pleural biopsies; eight guided drainages of empyema and haemothorax; 13 stagings of intrathoracic tumours; two explorations for penetrating thoracic trauma; seven talc insufflations, and two lobectomies. The median duration of post-operative chest tube drainage was two days and hospital stay four days. From April 1993 to April 1994 interventional bronchoscopy was performed on seven patients with obstructive tracheal and proximal bronchial lesions. Procedures consisted of three carbon dioxide laser reductions; two dilatations and carbon dioxide laser reductions, and two dilatations and placement of silicone Dumon stents. All patients showed immediate symptomatic improvement. We conclude that both procedures are safe and effective.

Hong Kong Med J 1995;1:115-22

Key words: Thoracic surgery; Operative surgery; Bronchoscopy