Thoracoscopy in pleural effusion--two techniques: awake single-access video-assisted thoracic surgery versus 2-ports video-assisted thoracic surgery under general anesthesia.

ABSTRACT

UNLABELLED Awake single access video-assisted thoracic surgery with local anesthesia improves procedure tolerance, reduces postoperative stay and costs. MATERIALS & METHODS: Local anesthesia was made with lidocaine and ropivacaine. We realize one 20 mm incision for the 'single-access', and two incisions for the '2-trocars technique'. RESULTS: Mortality rate was 0% in both groups. Postoperative stay 3 dd ± 4 versus 4 dd ± 5, mean operative time 39 min versus 37 min (p < 0.05). Chest tube duration 2dd ± 5 versus 3 dd ± 6. COMPLICATIONS 11/95 versus 10/79. CONCLUSION: Awake technique reduce postoperative hospital stay and chest drainage duration, similar complications and recurrence rate. The authors can say that 'awake single-access VATS' is an optimal diagnostic and therapeutic tool for the management of pleural effusions, but above extends surgical indication to high-risk patients.