Öz
Giriş: Video yardımlı göğüs cerrahisi (VATS) eksplorasyonu, göğüs cerrahisinde plevral biyopsi, mediastinal ve hiler lenfadenopati biyopsileri, hemotoraks, hava kaçağı kontrolü gibi durumlarda sıklıkla uygulanan bir cerrahi girişimdir. Bu çalışmada 497 hasta gözden geçirildi ve VATS eksplorasyonunun genişletilmiş endikasyonları incelendi.
Yöntemler: 2009-2019 yılları arasında radyolojik olarak intratorasik patoloji saptanan hastaların tamamı çalışmaya dahil edildi. Preoperatif, intraoperatif ve postoperatif bulgular retrospektif olarak değerlendirildi.
Bulgular: VATS eksplorasyonu için klinik endikasyonlar plevral efüzyon, intrapulmoner kitle, kistik lezyon, mediastinal lenfadenopati veya malignite ön tanısı ile araştırılan veya önceden bilinen maligniteye sekonder gelişen kitle, uzamış hava kaçağı ve/veya akciğer ekspansiyon sorunlarıydı, mediastinal kitle, hemotoraks, plevral kalınlaşma veya plevral nodül, göğüs duvarı tümörü, perikardiyal kist veya efüzyon, şilotoraks ve intratorasik kaviter lezyon idi. Bu endikasyonları olan tüm hastalar esas olarak VATS eksplorasyonu ile tedavi edildi.
Sonuç: Tanı konulan hastada opere edilebilirlik kriterlerinin değerlendirilmesi ve hedefe yönelik tedaviler için alt tip belirlenmesi, VATS eksplorasyonu ile kesin biyopsi alınabilmesi nedeniyle kesin tanı konulabilir ve fazla tedavilerin önüne geçilebilir. VATS eksplorasyonunu tüm intratorasik patolojiler için önemli bir adım olarak öneriyoruz.
Anahtar Kelimeler
Exploration intrathoracic pathology video-assisted thoracic surgery
Kaynakça
- Santambrogio L, Nosotti M, Bellaviti N, Mezzetti M. Videothoracoscopy versus thoracotomy for the diagnosis of the indeterminate solitary pulmonary nodule. Ann Thorac Surg. 1995; 59(4): 868–71.
- Pagès PB, Delpy JP, Falcoz PE, Thomas PA, Filaire M, Le Pimpec Barthes F, et al. Videothoracoscopy versus thoracotomy for the treatment of spontaneous pneumothorax: a propensity score analysis. Ann Thorac Surg. 2015; 99(1): 258–63.
- Martín T, Larraga R, Badorrey I, Bello S, Hernandez A, de Andres JL, et al. La videotoracoscopia frente a la toracotomía en el diagnóstico de la enfermedad intersticial difusa [Videothoracoscopy versus thoracotomy in the diagnosis of diffuse interstitial disease]. Arch Bronconeumol. 1997; 33(7): 341–5.
- Salo JA. The role of videothoracoscopy in the diagnosis and treatment of chest diseases. Ann Med. 1994; 26(6): 401–4.
- Abbas AE. Surgical Management of Lung Cancer: History, Evolution, and Modern Advances. Curr Oncol Rep. 2018; 20(12): 98.
- Kara M, Alzafer S, Okur E, Halezeroğlu S. The use of single incision thoracoscopic surgery in diagnostic and therapeutic thoracic surgical procedures. Acta Chir Belg. 2013; 113(1): 25–9.
- Lee P, Colt HG. Pleuroscopy in 2013. Clin Chest Med. 2013; 34(1): 81–91.
- Rusch VW, Bains MS, Burt ME, McCormack PM, Ginsberg RJ. Contribution of videothoracoscopy to the management of the cancer patient. Ann Surg Oncol. 1994; 1(2): 94–8.
- Dieter RA Jr, Kuzyçz GB. Complications and contraindications of thoracoscopy. Int Surg. 1997; 82(3): 232-9.
- Psallidas I, Kalomenidis I, Porcel JM, Robinson BW, Stathopoulos GT. Malignant pleural effusion: from bench to bedside [published correction appears in Eur Respir Rev. 2016 Sep; 25(141): 360] [published correction appears in Eur Respir Rev 2016 Sep; 25(141): 360]. Eur Respir Rev. 2016; 25(140): 189–98.
- Pereira RR, Alvim CG, Andrade CR, Ibiapina CDC. Parapneumonic pleural effusion: early versus late thoracoscopy. J Bras Pneumol. 2017; 43(5): 344–50.
- Aboudara M, Maldonado F. Update in the Management of Pleural Effusions. Med Clin North Am. 2019; 103(3): 475–85.
- Wan YY, Zhai CC, Lin XS, Yao ZH, Liu QH, Zhu L, et al. Safety and complications of medical thoracoscopy in the management of pleural diseases. BMC Pulm Med. 2019; 19(1): 125.
- Yalcin NG, Choong CK, Eizenberg N. Anatomy and pathophysiology of the pleura and pleural space. Thorac Surg Clin. 2013; 23(1): 1–10.
- Cohen LA, Light RW. Tuberculous Pleural Effusion. Turk Thorac J. 2015; 16(1): 1–9.
- Loscertales J, Jimenez-Merchan R, Congregado M, Ayarra FJ, Gallardo G, Triviño A. Video-assisted surgery for lung cancer. State of the art and personal experience. Asian Cardiovasc Thorac Ann. 2009; 17(3): 313–26.
- Wang GW, Tao T, Li CK, Li QC, Duan GX, Sang HW, et al. Comparison between thoracoscopic and open approaches in thymoma resection. J Thorac Dis. 2019; 11(10): 4159–68.
- Lang-Lazdunski L, Mouroux J, Pons F, Grosdidier G, Martinod E, Elkaïm D, et al. Role of videothoracoscopy in chest trauma. Ann Thorac Surg. 1997; 63(2): 327–33.
- Erşen E, Kılıç B, Kara HV, Iscan M, Alizade N, Demirkaya A, et al. Uniportal versus multiport video-assisted thoracoscopic surgery for anatomical lung resections: a glance at a dilemma. Wideochir Inne Tech Maloinwazyjne. 2018; 13(2): 215‐20.
- Varghese Jr TK. Decision Making: The Surgeon’s Perspective. In: Ferguson MK, editor. Difficult Decisions in Thoracic Surgery An Evidence-Based Approach. 3rd ed. London: Springer-Verlag, 2014. p. 47-57.
Öz
Background: Video-assisted thoracic surgery (VATS) exploration is a frequently performed surgical intervention in thoracic surgery in cases such as pleural biopsy, mediastinal and hilar lymphadenopathy biopsies, hemothorax, air leak control. In this study, 497 patients were reviewed and extended indications of VATS exploration were revealed.
Methods: All of the patients with radiologically detected intrathoracic pathology between 2009-2019 were included in the study. Preoperative, intraoperative and postoperative findings were evaluated retrospectively.
Results: The clinical indications for VATS exploration were pleural effusion, intrapulmonary mass, cystic lesion, mediastinal lymphadenopathy or mass that has been investigated with a pre-diagnosis of malignancy or developed secondary to previously known malignancy, prolonged air leakage and / or lung expansion problems, mediastinal mass, hemothorax, pleural thickening or pleural nodule, chest wall tumor, pericardial cyst or effusion, chylothorax, and intrathoracic cavitary lesion. All patients with these indications were managed mainly with VATS exploration.
Conclusion: Evaluation of operability criteria, and subtype determination for targeted therapies in the diagnosed patient, definitive diagnosis can be made and over-treatments can be prevented due to the precise biopsies can be taken with VATS exploration. We recommend the VATS exploration as a key step for all intrathoracic pathologies.
Anahtar Kelimeler
Exploration intrathoracic pathology video-assisted thoracic surgery
Kaynakça
- Santambrogio L, Nosotti M, Bellaviti N, Mezzetti M. Videothoracoscopy versus thoracotomy for the diagnosis of the indeterminate solitary pulmonary nodule. Ann Thorac Surg. 1995; 59(4): 868–71.
- Pagès PB, Delpy JP, Falcoz PE, Thomas PA, Filaire M, Le Pimpec Barthes F, et al. Videothoracoscopy versus thoracotomy for the treatment of spontaneous pneumothorax: a propensity score analysis. Ann Thorac Surg. 2015; 99(1): 258–63.
- Martín T, Larraga R, Badorrey I, Bello S, Hernandez A, de Andres JL, et al. La videotoracoscopia frente a la toracotomía en el diagnóstico de la enfermedad intersticial difusa [Videothoracoscopy versus thoracotomy in the diagnosis of diffuse interstitial disease]. Arch Bronconeumol. 1997; 33(7): 341–5.
- Salo JA. The role of videothoracoscopy in the diagnosis and treatment of chest diseases. Ann Med. 1994; 26(6): 401–4.
- Abbas AE. Surgical Management of Lung Cancer: History, Evolution, and Modern Advances. Curr Oncol Rep. 2018; 20(12): 98.
- Kara M, Alzafer S, Okur E, Halezeroğlu S. The use of single incision thoracoscopic surgery in diagnostic and therapeutic thoracic surgical procedures. Acta Chir Belg. 2013; 113(1): 25–9.
- Lee P, Colt HG. Pleuroscopy in 2013. Clin Chest Med. 2013; 34(1): 81–91.
- Rusch VW, Bains MS, Burt ME, McCormack PM, Ginsberg RJ. Contribution of videothoracoscopy to the management of the cancer patient. Ann Surg Oncol. 1994; 1(2): 94–8.
- Dieter RA Jr, Kuzyçz GB. Complications and contraindications of thoracoscopy. Int Surg. 1997; 82(3): 232-9.
- Psallidas I, Kalomenidis I, Porcel JM, Robinson BW, Stathopoulos GT. Malignant pleural effusion: from bench to bedside [published correction appears in Eur Respir Rev. 2016 Sep; 25(141): 360] [published correction appears in Eur Respir Rev 2016 Sep; 25(141): 360]. Eur Respir Rev. 2016; 25(140): 189–98.
- Pereira RR, Alvim CG, Andrade CR, Ibiapina CDC. Parapneumonic pleural effusion: early versus late thoracoscopy. J Bras Pneumol. 2017; 43(5): 344–50.
- Aboudara M, Maldonado F. Update in the Management of Pleural Effusions. Med Clin North Am. 2019; 103(3): 475–85.
- Wan YY, Zhai CC, Lin XS, Yao ZH, Liu QH, Zhu L, et al. Safety and complications of medical thoracoscopy in the management of pleural diseases. BMC Pulm Med. 2019; 19(1): 125.
- Yalcin NG, Choong CK, Eizenberg N. Anatomy and pathophysiology of the pleura and pleural space. Thorac Surg Clin. 2013; 23(1): 1–10.
- Cohen LA, Light RW. Tuberculous Pleural Effusion. Turk Thorac J. 2015; 16(1): 1–9.
- Loscertales J, Jimenez-Merchan R, Congregado M, Ayarra FJ, Gallardo G, Triviño A. Video-assisted surgery for lung cancer. State of the art and personal experience. Asian Cardiovasc Thorac Ann. 2009; 17(3): 313–26.
- Wang GW, Tao T, Li CK, Li QC, Duan GX, Sang HW, et al. Comparison between thoracoscopic and open approaches in thymoma resection. J Thorac Dis. 2019; 11(10): 4159–68.
- Lang-Lazdunski L, Mouroux J, Pons F, Grosdidier G, Martinod E, Elkaïm D, et al. Role of videothoracoscopy in chest trauma. Ann Thorac Surg. 1997; 63(2): 327–33.
- Erşen E, Kılıç B, Kara HV, Iscan M, Alizade N, Demirkaya A, et al. Uniportal versus multiport video-assisted thoracoscopic surgery for anatomical lung resections: a glance at a dilemma. Wideochir Inne Tech Maloinwazyjne. 2018; 13(2): 215‐20.
- Varghese Jr TK. Decision Making: The Surgeon’s Perspective. In: Ferguson MK, editor. Difficult Decisions in Thoracic Surgery An Evidence-Based Approach. 3rd ed. London: Springer-Verlag, 2014. p. 47-57.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Original Article |
| Yazarlar | |
| Erken Görünüm Tarihi | 29 Aralık 2023 |
| Yayımlanma Tarihi | 31 Aralık 2023 |
| Gönderilme Tarihi | 9 Şubat 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 33 Sayı: 6 |
Genel Tıp Dergisi Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı (CC BY NC) ile lisanslanmıştır.