Korean J Thorac Cardiovasc Surg.  2000 Sep;33(9):738-743.

A Comparison on the Operative Results of Benign Esophageal Disease by Video-Assisted Thoracic Surgery and Thoracotomy

• Jung SH
• Park SI
• Oh JH
• Song TS
• Kim HJ
• Kim DK
• Shon KH
• Choi IC

Abstract

BACKGROUND
Video-assisted thoracic surgery (VATS) is being used as a therapeutic modality in many diseases in which thoracotomy has been used. We studied that the VATS can substitute the thoracotomy in benign esophageal disease. MATERIAL AND METHOD: Group I (n=18) underwent video-assisted thoracic surgery, and group II (n=19) thoracotomy. Group I includes 14 leiomyomas and 4 achalasias. Group II includes 16 leiomyomas and 3 achalasias. Operative technique is enucleation in the leiomyoma and modified Heller's myotomy in the achalasia. Analyzing factors of operation-efficacy are anesthetic time, operation time, hospital stay, chest tube drainage amount and chest tube removal day. The degree of the postoperative pain is assessed by the frequency of opioid analgesics injection. RESULT: There was no death in both groups. There were 5 complications in the group I and 2 in the group II. Prolonged pleural effusion and restenosis of achalasia occurred to 1 patient in each group. In the group I, there were 1 temporaty vocal cord palsy and 2 mucosal tear leading to thoracotomy. There were no differences in anesthesia time, operation time, hospital stay, total chest tube drainage amount, chest tube removal day and frequency of opioid analgesics injection. The amount of the chest tube drainage at POD 1 day was significantly lower in group I (155.6+/-77.8cc) than in group II (572.8+/-280.1cc) (p<0.05).
CONCLUSION
The results of our data showed that video-assisted thoracic surgery for benign esophageal disease is as effective as thoracotomy and in addition, cosmetic effect is much better. We concluded VATS may be a substitute for thoracotomy in benign esophageal disease.

MeSH Terms

Analgesics, Opioid
Anesthesia
Chest Tubes
Drainage
Esophageal Achalasia
Esophageal Diseases*
Humans
Leiomyoma
Length of Stay
Pain, Postoperative
Pleural Effusion
Thoracic Surgery, Video-Assisted*
Thoracotomy*
Vocal Cord Paralysis
Analgesics, Opioid