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Video-assisted Thoracoscopic Total Pleural Adhesiolysis:Tips and Pitfalls Mitsuhiro Kamiyoshihara 1 , Hitoshi Igai 1 , Natsumi Matsuura 1 , Fumi Ohsawa 1 , Kazuki Numajiri 1 , Tomohiro Yazawa 2 , Toshiki Yajima 2 , Ken Shirabe 2 1Department of General Thoracic Surgery, Japanese Red Cross Maebashi Hospital Keyword: pleural adhesion , video-assisted thoracoscopic surgery , adhesiolysis pp.504-508
Published Date 2021/7/1
DOI https://doi.org/10.15106/j_kyobu74_504
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Purposes:Here, we present the tips and pitfalls of video-assisted thoracoscopic (VATS) total pleural adhesiolysis (TPA), determined on an empirical basis.

Patients and Methods:From 2012 to 2020, VATS-TPA was performed in 33 patients undergoing pulmonary anatomic lung resection at our institute. The basic procedure was as follows:after peeling off the area of pleural adhesion surrounding the surgical ports using the fingers, the thoracoscope was inserted into the thorax and the adhesions in other areas were peeled off under thoracoscopic guidance.

Results:The adhesiolysis group had a longer operating time, greater blood loss, and higher rate of conversion to thoracotomy compared to the non-adhesiolysis group. However, the results were acceptable considering the extra manipulation for adhesiolysis.

Conclusions:VATS-TPA is a necessary component of the standard surgical procedure for general thoracic surgeons in cases of total pleural adhesion.


© Nankodo Co., Ltd., 2021

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電子版ISSN 2432-9436 印刷版ISSN 0021-5252 南江堂

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