Video-assisted thoracoscopic surgery in diagnosis and treatment of pleuritis

Medicina (Kaunas). 2004;40 Suppl 1:145-8. [Link]

Piscikas DA, Cicenas S, Jackevicius A, Krasauskas A, Jakubauskiene R.

Institute of Oncology, Vilnius University, Santariskiu 1, 2021 Vilnius, Lithuania. vuoipiscikas@yahoo.com

Abstract

Objective: To evaluate possibilites of video-assisted thoracoscopic surgery in diagnosis and treatment of pleuritis. 1997-2002 in Department of Thoracic Surgery and Oncology of Vilnius University Institute of Oncology 206 patients underwent videothoracoscopic procedures (146 (70.8%) of them for pleuritis). All procedures were performed in general anesthesia using double lumen tube. Mean patient age was 61+/-10 years. One hundred three women (71%) and 43 men (29%) were operated. Seventy four (51%) chemopleurodesis was performed with pleural biopsies: for 2 patients (1.36%) bleocine was used, and for 74 patients (50.6%) sterile talk.

Results: Significance of pleural videobiopsies reaches 93%. Eleven patients (7%) failed in diagnosis: in 5 cases (3.4 %) due to adhesions, in 6 cases (3.4%) we made false positive diagnosis. Complications: postoperative pneumonia – 12 patients (8.8%), pneumothorax – 2 patients (1.5%), pleural empiema – 1 patient (0.75%), bleeding – 1 patient (0.75%).

Conclusions: Specificity of video-assisted thoracoscopic surgery in pleural diseases reaches 93.0%. Video-assisted thoracoscopic surgery is necessary even in cases of failed "blind" biopsies and possible in elderly patients. Video-assisted thoracoscopic surgery provides not only easy morphologic verification of pleural diseases but also performance of chemopleurodesis.