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.
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Pfannschmidt, J. (2022). Videothorakoskopie (VATS). In: Hoffmann, H., Ludwig, C., Passlick, B. (eds) Thoraxchirurgie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-59159-8_21-1
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