Intraoperative conversion from thoracoscopy to thoracotomy in anatomical lung resections

OBJECTIVE. Despite the increasingly use of video-assisted approaches in thoracic surgery, intraoperative conversion from minimally invasive to «open» takes place quite often, especially during anatomical lung resection. METHODS AND MATERIALS. A retrospective analysis 106 consecutive resections (lobectomies) initiated by thoracoscopic access was performed. The patients were divided into two groups: a group 90 without and 16 (15%) who required before thoracotomy. We analyzed reasons for conversion, attempted predict estimated effect on postoperative course. RESULTS. conversions were: absence an interlobar fissure – 5 (31 %), bleeding 4 (25 discrepancy between CT situation 2 (13 intrapleural adhesions variant anatomy pulmonary vessels bronchi lymph nodes invasion main 1 (6 %). Conversions «forced» (in order stop bleeding) «unforced» prevent development possible complications unjustified prolongation duration operation). There no significant difference frequency early after “unforced” operated according plan thoracoscopy. Prolonged air leakage noted out (31.3 %) 35 (38.9 thoracoscopy (p=0.28). severity pain syndrome 24 hours surgery assessed visual analogue scale also comparable; average values assessment 3+2 4+2 (p=0.19). CONCLUSION. “Unforced” lobectomies is not accompanied increasing incidence complications; it should be considered as natural course operation reduce surgery.