Video Yardımlı Göğüs Cerrahisi Cerrahi Karar Vermenin Neresinde?: 497 Olgunun Değerlendirilmesi

Year 2023, Volume: 33 Issue: 6, 670 - 675, 31.12.2023

Atilla Can , Hüseyin Yıldıran , Güven Sadi Sunam , Halil Şen

https://doi.org/10.54005/geneltip.1249508

Abstract

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.

Keywords

Exploration, intrathoracic pathology, video-assisted thoracic surgery

Where is the Video-Assisted Thoracic Surgery Truth In Making Decision?: Evaluation of 497 Cases

Abstract

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.

Keywords

Exploration, intrathoracic pathology, video-assisted thoracic surgery

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