Zusammenfassung
Die videoassistierte Thoraxchirurgie (VATS) hat sich in 1990er-Jahren aus der internistischen Thorakoskopie entwickelt und seither zunehmend an Bedeutung gewonnen. Als entscheidende Vorteile gegenüber der Thorakotomie haben sich das geringere Gewebetrauma, geringere frühpostoperative Schmerzen, ein verbessertes kosmetisches Ergebnis sowie deutlich verkürzte Krankenhausliegezeiten und damit verbunden, reduzierte medizinische Kosten gezeigt. Die Indikation zum VATS-Eingriff hat sich in hoch spezialisierten Zentren auf nahezu sämtliche Bereiche der Thoraxchirurgie ausgedehnt. Nur noch wenige Eingriffe gelten als Kontraindikationen der VATS, so Resektionen bei sehr großen Tumoren, Notfalleingriffe oder Pancoast-Tumore. Weiterentwicklungen stellen heute die uniportale VATS, der subxiphoidale Zugangsweg sowie die roboterassistierte Chirurgie dar. Umfangreiche, prospektiv randomisierte Untersuchungen, die den Vorteil eines der Verfahren klar belegen, liegen nicht vor. Wichtig ist die Bewertung intraoperativer Komplikationen, die bei richtiger Einschätzung den Umstieg zum offenen Verfahren zügig erfolgen lässt und damit den Patienten keinen weiteren Gefahren aussetzt.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
Literatur
Akter F, Routledge T, Toufektzian L, Attia R (2015) In minor and major thoracic procedures is uniport superior to multiport video-assisted thoracoscopic surgery? Interact Cardiovasc Thorac Surg 20(4):550–555. https://doi.org/10.1093/icvts/ivu375
Bendixen M, Jørgensen OD, Kronborg C, Andersen C, Licht PB (2016) Postoperative pain and quality of life after lobectomy via video-assisted thoracoscopic surgery or anterolateral thoracotomy for early stage lung cancer: a randomised controlled trial. Lancet Oncol 17(6):836–844. https://doi.org/10.1016/S1470-2045(16)00173-X
Ceppa DP, Kosinski AS, Berry MF, Tong BC, Harpole DH, Mitchell JD, … Onaitis MW (2012) Thoracoscopic lobectomy has increasing benefit in patients with poor pulmonary function. Ann Surg, 256(3):487–493. https://doi.org/10.1097/SLA.0b013e318265819c
Cerfolio RJ, Bryant AS (2008) Does minimally invasive thoracic surgery warrant fast tracking of thoracic surgical patients? Thorac Surg Clin 18(3):301–304. https://doi.org/10.1016/j.thorsurg.2008.05.002
Ciriaco P, Muriana P, Negri G (2017) Pulmonary nodules and mini-invasive lung resection: do we have the right „tool“ for their intraoperative localization? J Thorac Dis 9(11):4216–4218. https://doi.org/10.21037/jtd.2017.10.87
Deng H-Y, Zhu Z-J, Wang Y-C, Wang W-P, Ni P-Z, Chen L-Q (2016) Non-intubated video-assisted thoracoscopic surgery under loco-regional anaesthesia for thoracic surgery: a meta-analysis. Interact Cardiovasc Thorac Surg 23(1):31–40. https://doi.org/10.1093/icvts/ivw055
Downey RJ, McCormack P, LoCicero J (1996) Dissemination of malignant tumors after video-assisted thoracic surgery: a report of twenty-one cases. The Video-Assisted Thoracic Surgery Study Group. J Thorac Cardiovasc Surg 111(5):954–960. http://www.ncbi.nlm.nih.gov/pubmed/8622319
Gkikas A, Lampridis S, Patrini D, Kestenholz Peter B, Scarci M, Minervini F (2022) How effective is indocyanine green (ICG) in localization of malignant pulmonary nodules? A systematic review and meta-analysis. Front Surg 9:967897. https://doi.org/10.3389/fsurg.2022.967897
Gonzalez D, Paradela M, Garcia J, dela Torre, M (2011) Single-port video-assisted thoracoscopic lobectomy. Interact Cardiovasc Thorac Surg 12(3):514–515. https://doi.org/10.1510/icvts.2010.256222
Gonzalez-Rivas D (2016) Uniportal thoracoscopic surgery: from medical thoracoscopy to non-intubated uniportal video-assisted major pulmonary resections. Ann Cardiothorac Surg 5(2):85–91. https://doi.org/10.21037/acs.2016.03.07
Gonzalez-Rivas D, Xie B, Yang Y, Jiang G (2015) Uniportal video-assisted thoracoscopic lobectomy with en bloc chest wall resection. J Visualized Surg 1:7. https://doi.org/10.3978/j.issn.2221-2965.2015.07.01
Gonzalez-Rivas D, Bonome C, Fieira E, Aymerich H, Fernandez R, Delgado M, … de la Torre M (2016) Non-intubated video-assisted thoracoscopic lung resections: the future of thoracic surgery? Eur J Cardiothorac Surg 49(3):721–731. https://doi.org/10.1093/ejcts/ezv136
Gonzalez-Rivas D, Lirio F, Sesma J, Abu Akar F (2017) Subxiphoid complex uniportal video-assisted major pulmonary resections. J Visualized Surg 3:93. https://doi.org/10.21037/jovs.2017.06.02
Grünfeld J (2018) Zur Geschichte der Endoskopie und der Endoskopischen Apparate (Classic Reprint). Forgotten Books, London
Gu Z, Wang H, Mao T, Ji C, Xiang Y, Zhu Y, Fang W et al (2018) Pulmonary function changes after different extent of pulmonary resection under video-assisted thoracic surgery. J Thorac Dis 10(4):2331–2337. https://doi.org/10.21037/jtd.2018.03.163
Guido-Guerrero W, Bolaños-Cubillo A, González-Rivas D (2018) Single-port video-assisted thoracic surgery (VATS)-advanced procedures & update. J Thorac Dis 10(Suppl 14):S1652–S1661. https://doi.org/10.21037/jtd.2018.05.43
Hirai K, Takeuchi S, Usuda J (2016) Single-incision thoracoscopic surgery and conventional video-assisted thoracoscopic surgery: a retrospective comparative study of perioperative clinical outcomes†. Eur J Cardiothorac Surg 49(Suppl 1):i37–i41. https://doi.org/10.1093/ejcts/ezv320
Imperatori A, Rotolo N, Gatti M, Nardecchia E, De Monte L, Conti V, Dominioni L (2008) Peri-operative complications of video-assisted thoracoscopic surgery (VATS). Int J Surg 6:S78–S81. https://doi.org/10.1016/j.ijsu.2008.12.014
Jacobaeus (1910) Über die Moglichkeit, die Zystoskopie bei Untersuchung seröser Höhlungen anzuwenden. Munch Med Wochenschr 57:2090–2092
Keenan RJ, Landreneau RJ, Hazelrigg SR, Ferson PF (1995) Video-assisted thoracic surgical resection with the neodymium:yttrium-aluminum-garnet laser. J Thorac Cardiovasc Surg 110(2):363–367. https://doi.org/10.1016/S0022-5223(95)70231-8
Kothapalli PR, Wyler von Ballmoos MC, Chinnadurai P, Lumsden AB, Ramchandani MK (2019) Value of the hybrid operating theater for an integrated approach to diagnosis and treatment of pulmonary nodules in 2019. Front Surg 6:36. https://doi.org/10.3389/fsurg.2019.00036
Lewis RJ, Sisler GE, Caccavale RJ (1992) Imaged thoracic lobectomy: should it be done? Ann Thorac Surg 54(1):80–83. http://www.ncbi.nlm.nih.gov/pubmed/1319134
Lim E, Batchelor T, Dunning J, Shackcloth M, VIOLET Trialists (2019) In hospital clinical efficacy, safety, and oncologic outcomes from VIOLET: a UK multicenter RCT of VATS versus open lobectomy for lung cancer. Abstract PL02.06. IASLC 2019 world conference on lung cancer|Abstracts 6
McKenna RJ (2008) Complications and learning curves for video-assisted thoracic surgery lobectomy. Thorac Surg Clin 18(3):275–280. https://doi.org/10.1016/j.thorsurg.2008.04.004
McKenna RJ, Houck W, Fuller CB (2006) Video-assisted thoracic surgery lobectomy: experience with 1,100 cases. Ann Thorac Surg 81(2):421–425; discussion 425–426. https://doi.org/10.1016/j.athoracsur.2005.07.078
Meyer C, Bartsch D, Mirow N, Kirschbaum A (2017) Video-assisted laser resection of lung metastases – feasibility of a new surgical technique. Thorac Cardiovasc Surg 65(05):382–386. https://doi.org/10.1055/s-0036-1597990
Onaitis MW, Petersen RP, Balderson SS, Toloza E, Burfeind WR, Harpole DH, D’Amico TA (2006) Thoracoscopic lobectomy is a safe and versatile procedure: experience with 500 consecutive patients. Ann Surg 244(3):420–425. https://doi.org/10.1097/01.sla.0000234892.79056.63
Oparka J, Yan TD, Ryan E, Dunning J (2013) Does video-assisted thoracic surgery provide a safe alternative to conventional techniques in patients with limited pulmonary function who are otherwise suitable for lung resection? Interact Cardiovasc Thorac Surg 17(1):159–162. https://doi.org/10.1093/icvts/ivt097
Passlick B, Born C, Sienel W, Thetter O (2001) Incidence of chronic pain after minimal-invasive surgery for spontaneous pneumothorax. Eur J Cardiothorac Surg 19(3):355–358; discussion 358–359. https://doi.org/10.1016/s1010-7940(01)00568-1
Pompeo E, Mineo D, Rogliani P, Sabato AF, Mineo TC (2004) Feasibility and results of awake thoracoscopic resection of solitary pulmonary nodules. Ann Thorac Surg 78(5):1761–1768. https://doi.org/10.1016/j.athoracsur.2004.05.083
Rocco G, Martin-Ucar A, Passera E (2004) Uniportal VATS wedge pulmonary resections. Ann Thorac Surg 77(2):726–728. https://doi.org/10.1016/S0003-4975(03)01219-0
Schilling T, Kozian A, Huth C, Bühling F, Kretzschmar M, Welte T, Hachenberg T (2005) The pulmonary immune effects of mechanical ventilation in patients undergoing thoracic surgery. Anesth Analg 101(4):957–965. https://doi.org/10.1213/01.ane.0000172112.02902.77
Schulze M-K, Eichfeld U, Kahn T, Stumpp P (2012) CT-gestützte Drahtmarkierung vor videoassistierter thorakoskopischer OP von pulmonalen Rundherden – eine Auswertung von 184 Fällen. RöFo 184(06):535–541. https://doi.org/10.1055/s-0031-1299418
Semm K (1982) Advances in pelviscopic surgery. Prog Clin Biol Res 112 Pt B:127–149. http://www.ncbi.nlm.nih.gov/pubmed/7163307
Sihoe ADL (2014) The evolution of minimally invasive thoracic surgery: implications for the practice of uniportal thoracoscopic surgery. J Thorac Dis 6(Suppl 6):S604–S617. https://doi.org/10.3978/j.issn.2072-1439.2014.08.52
Solaini L, Prusciano F, Bagioni P, di Francesco F, Solaini L, Poddie DB (2008) Video-assisted thoracic surgery (VATS) of the lung: analysis of intraoperative and postoperative complications over 15 years and review of the literature. Surg Endosc 22(2):298–310. https://doi.org/10.1007/s00464-007-9586-0
Suda K, Sato K, Mizuuchi H, Kobayashi Y, Shimoji M, Tomizawa K, … Mitsudomi T (2014) Recent evidence, advances, and current practices in surgical treatment of lung cancer. Respir Investig 52(6):322–329. https://doi.org/10.1016/j.resinv.2014.06.003
Suda T (2017) Subxiphoid uniportal video-assisted thoracoscopic surgery procedure. Thorac Surg Clin 27(4):381–386. https://doi.org/10.1016/j.thorsurg.2017.06.006
Swanson SJ, Herndon JE, D’Amico TA, Demmy TL, McKenna RJ, Green MR, Sugarbaker DJ (2007) Video-assisted thoracic surgery lobectomy: report of CALGB 39802 – a prospective, multi-institution feasibility study. J Clin Oncol Off J Am Soc Clin Oncol 25(31):4993–4997. https://doi.org/10.1200/JCO.2007.12.6649
Yang X, Wang L (2018) Subxiphoid uniportal video-assisted thoracoscopic surgery for synchronous bilateral lung resection. Postgrad Med 130(1):142–145. https://doi.org/10.1080/00325481.2018.1398048
Zhi X, Gao W, Han B, Yang Y, Li H, Liu D, China Clinical Trials Consortium et al (2013) VATS lobectomy facilitates the delivery of adjuvant docetaxel-carboplatin chemotherapy in patients with non-small cell lung cancer. J Thorac Dis 5(5):578–584. https://doi.org/10.3978/j.issn.2072-1439.2012.02.05
Zinne N, Kropivnitskaya I, Selman A, Merz C, Golpon H, Haverich A, Zardo P (2018) Minimal-invasive anatomische Lungenresektionen unter Spontanatmung. Z Herz-, Thorax-Gefäßchirurgie 33(1):20–24. https://doi.org/10.1007/s00398-018-0274-2
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Section Editor information
Rights and permissions
Copyright information
© 2023 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature
About this chapter
Cite this chapter
Pfannschmidt, J. (2023). Videothorakoskopie (VATS). In: Hoffmann, H., Ludwig, C., Passlick, B. (eds) Thoraxchirurgie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-59146-8_21
Download citation
DOI: https://doi.org/10.1007/978-3-662-59146-8_21
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-59145-1
Online ISBN: 978-3-662-59146-8
eBook Packages: Medicine (German Language)