Video-assisted thoracoscopic pulmonary surgery — current status and potential evolution

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Abstract
The current status of video-assisted thoracoscopic surgery (VATS) of thelung has been reviewed. The published data support the view that VATSpulmonary surgery is feasible and safe. It is associated with decreasedperioperative pain and opiate requirement, better postoperative pulmonaryfunction, and probable overall neutral cost impact. A VATS approach isfunctionally superior to open thoracotomy for wedge resection, pneumothoraxsurgery and bullous lung disease and may allow surgical intervention inpatients with pulmonary function which is in adequate for open resection.Major VATS pulmonary resection with lobectomy and pneumonectomy can beperformed for early malignant disease without compromising establishedsurgical principles. Specific training is needed in VATS surgery andbackground skills in general thoracic surgery are necessary to underwritemajor interventions. Decreased cytokine activation and enhanced postsurgical immune function may prove to be long-term benefits of VATSsurgery.

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