Videothoracoscopy experience within a year in a secondary care hospital: Evaluation of 26 patients

INTRODUCTION: In this study we aimed to evaluate the efficacy of video-assisted thoracoscopy (VATS) on diagnosis and treatment of pleural and lung pathologies.
METHODS: Twenty-six patients underwent VATS due to pleural effusion, plevral nodularity and, peripheric lung nodule between June 2009 and June 2010.
RESULTS: Out of 26 patients; 18 were male and 8 were female. Mean age was 60,8 (range 31-80). Twenty-five patients receved general anaesthesia, and procedure was performed with local anaesthesia and sedation due to cardiac problems in one patient. VATS was performed in right hemithorax in 12 patients and in left hemithorax in 14 patients. In 11 patients (42%) pleural effusion, in 19 patients (73%) pleural thickening and in 2 patients (7,7%) peripheric lung pathology were detected in preoperative evaluation. Pleural thickening were accompanied to pleural effusion in 7 patients. Malign mesothelioma was detected in 7 patients, adenocarcinoma was detected in 1 patient, malign epithelial tumor was detected in 1 patient, small cell lung cancer was detected in 1 patient, pleural tuberculosis was detected in 2 patients, non-necrotizing granulomatous pleuritis was detected in 2 patients and non-specific pleuritis was detected in
12 patient. One patient was diagnosed to have pleural effusion due to romathoid arthritis
during follow up which had been diagnosed as non-specific pleuritis by VATS. Diagnosis rate of VATS in benign disease, malign disease and in total were 93,7%, 90% and 92,3% respectively. Persistent air leak was observed in 1 patient and inadequate expansion was observed in 2 patients with malignant mesothelioma.
DISCUSSION AND CONCLUSION: VATS is a safe and efficient procedure in diagnosis and treatment of pleural and peripheric pulmonary diseases.

İkinci Basamak Bir Hastanede 1 Yıllık Videotorakoskopi Deneyimimiz: 26 Hastanın Değerlendirilmesi

GİRİŞ ve AMAÇ: Bu çalışmada plevra ve akciğer patolojilerinin tanı ve tedavisinde videotorakoskopi (VATS) işleminin etkinliğinin değerlendirilmesi amaçlandı.
YÖNTEM ve GEREÇLER: Sivas Numune Hastanesinde Haziran 2009 Haziran 2010 tarihleri arasında plevral efüzyon, plevral kal›nlaflma ve periferik parankimal patoloji nedeniyle VATS uygulanan 26 hasta incelendi.
BULGULAR: Hastaların 18’i erkek (%69), 8’i bayan (%31) yaş aralığı 31-80, ortalama 60,8
olarak bulundu. Hastaların 25‘ine genel anestezi, 1 hastaya kardiyolojik problemleri nedeniyle lokal anestezi ve sedasyon uygulandı. İşlem 12 hastaya sağ hemitorakstan
14’üne sol hemotorakstan yapıldı. Preoperatif radyolojik değerlendirmede hastaların
11’inde (%42) plevral efüzyon, 19’unda (%73) plevral kalınlaşma ve 2’sinde (%7,7) periferik parankimal patoloji mevcuttu. Yedi hastada plevral efüzyona plevral kalnlaşma eşlik ediyordu. Hastaların 7’sine malign mezotelyoma, 1’ine adenokarsinom, 1’ine malign epitelyal tümör, 1’ine küçük hücreli akciğer karsinomu, 2’sine tüberküloz, 2’sine non kazeifiye granülomatoz plörit ve 12’sine non spesifik plörit teşhisi konuldu. Non spesifik plörit teflhisi konulan bir hastanın takibinde romatoid artritin toraks tutulumu olduğu belirlendi. VATS’ın kesin tanı koyma oranı benign hastalıklarda %93,7, malign hastalıklarda %90 ve toplamda ise %92,3 olarak tespit edildi. Bir hastada uzamış hava kaçağı ve mezotelyoma tanısı konan 2 hastada akci¤ğr ekspansiyon kusuru gözlendi.
TARTIŞMA ve SONUÇ: Plevral ve periferik parankimal hastalıkların tanı ve tedavisinde VATS güvenilir ve etkin bir yöntemdir.