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[Incidents and complications of therapeutic thoracoscopy. Apropos of 898 operated patients].

The exceptional interest in endoscopic surgery, both in laparoscopic surgery and video-assisted thoracoscopic surgery have led many teams to widen their indications. This movement has developed into a revolution in techniques demanded by patients, the public, and the medias, requiring many practicians to use these techniques more and more often and consequently to attempt very delicate operations. This "explosion" of endoscopic techniques has largely benefited from advances in equipment development (optics, video instrumentation) but has also required that operators acquire rigorous procedures for the proposed techniques. With the development of new thoracoscopic techniques for therapeutic indications, there are an unavoidable number of incidents and complications. These incidents and complications are related both to the use of instruments undoubtedly not well enough adapted to the procedures used and also to "forced" indications. We humbly recognize that a certain number of incidents are related to the necessarily inadequate experience of the operators during the "run in" period. We emphasize that video-assisted thoracoscopic surgery is a complementary technique among the available therapeutic armamentarium. We evaluated the mid and long term results of cancerology exeresis with these two techniques and underscore that morbidity and complications are rare but sometimes unacceptable. In conclusion, whatever the form of the technique used, it is an important evolution in surgery which must abide by the classical rules, in particular for indications in cancer surgery.

Endoscopy↗

Thoracoscopy in the management of intrathoracic neurogenic tumors.

Video-assisted thoracoscopic surgery (VATS) has emerged as a minimally invasive therapy of intrathoracic neurogenic tumors, when the diseases occur in the adult and show no intraspinal extension. We have reviewed five cases: three tumors arose from the sympathetic chain with no intraspinal extension, vagus nerve in one, and intercostal nerve in one. For all five patients, hospitalization was brief, recovery was relatively rapid, and long-term results were excellent. We believe that when the indication for the treatment of patients with an intrathoracic neurogenic tumor are met in the adult, the procedure of choice should be the VATS approach.

Adolescent↗