Video-assisted thoracic surgery

Ann Thorac 1995;60%-59

PRACTICE

Surg

Video-Assisted Diagnosis:

518

Other

515-517

Pneumonopathy

500-508

Pneumoconiosis

495

Alveolitis

480-487

Pneumonia

Indication:

Confirmation of Indication:

Contraindications:

Actions Prior to Procedure:

Actions During Procedure:

Actions

Following Procedure:

Outcome:

Complications:

s35

Surgery

disease of the lung

Solitary Procedure:

Thoracic

GUIDELINES

pulmonary

nodule

32095

Thoracotomy,

limited

32500

Wedge

1)

Unexplained

2)

Peripheral

1)

Chest x-ray in all cases

2)

Chest CT scan or MRI scan necessary

1)

Inability

to tolerate

general

2)

Inability

to tolerate

one-lung

3)

Obliteration

of the pleural

4)

Uncorrected

severe coagulopathy

1)

Review

2)

Bronchoscopy infections

3)

Room air blood suspected

1)

Obtain

2)

Specimen

3)

Send specimens

4)

Insert chest tube for pleural

5)

Proceed to thoracotomy if appropriate lung ventilation not tolerated

1)

Obtain

2)

Remove

1)

Intraoperative

2)

Obtain

1)

Prolonged

2)

Pneumonia

3)

Hemorrhage

resection

for biopsy

of lung

interstitial

single

or multiple

or alveolar

pulmonary

radiographic

of lung or pleura

nodule

infiltrate

located

space

studies

resection

(with

to pathology

chest x-ray to ensure chest tube following mortality

air leak


tracheobronchial evaluation

adequate

bag should

representative

nodules

anesthesia

gases for baseline

retrieval

for pulmonary

of lung

anesthesia

to rule out proximal

wedge

in the outer third

and, when

if significant

margin

be employed

abnormalities

when

when

pulmonary

compromise

indicated)

malignancy

appropriate,

and pulmonary

suspected

microbiology

laboratories

drainage tissue not obtainable

full lung expansion cessation

via VATS

and rule out bleeding

of air leak (if present)

or if single-

536

PRACTICE

Ann Thorac Surg 1995;6O:S3-59

GUIDELINES

4)

Empyema

5)

Possible

6)

Prolonged

need for thoracotomy ventilator

dependency

References 1. Miller DL, Allen MS, Trastek VF, Deschamps C, Pairolero PC. Videothoracoscopic wedge excision of the lung. Ann Thorac Surg 1992;54:410-4. 2. Landreneau RJ, Hazelrigg SR, Ferson PF, et al. Thoracoscopic resection of 85 pulmonary lesions. Ann Thorac Surg 1992;54:415-20. 3. Kaiser LR. DiEuse lung disease. In: Kaiser LR, Daniel TM, eds. Thoracoscopic surgery. Boston: Little, Brown, 1993:97-107.