ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Thoracoscopy under local anesthesia for patients with a high cardiopulmonary risk index
Gökhan Yuncu1, Cansel Atınkaya1, Figen Türk1, Göksel Kıter2, Tolga Semerkant1
1Departments of Thoracic Surgery, Medical Faculty of Pamukkale University, Denizli, Turkey
2Departments of Chest Disease, Medical Faculty of Pamukkale University, Denizli, Turkey
DOI : 10.5606/tgkdc.dergisi.2012.104
Background: In this study, we aimed to investigate the efficacy of thoracoscopy performed under local anesthesia and sedation for the diagnosis and treatment of patients with a high cardiopulmonary risk index.

Methods: Between January 2007 and October 2010, 32 patients (22 males, 10 females; mean age 63.6 years; range 36 to 89 years) with a high cardiopulmonary risk index who underwent thoracoscopy under local anesthesia and sedation at Pamukkale University, School of Medicine, Department of Thoracic Surgery were included. Risk assessment was performed using the cardiopulmonary risk index. All procedures were performed in the operating room.

Results: The cardiopulmonary risk index points of the patients ranged from 7 to 37 (mean 13.6). None of the patients underwent general anesthesia, indotracheal intubation, or epidural or intercostal blockage. Pleural biopsy/effusion drainage, either with or without talc pleurodesis, was performed in fifteen patients, six had drainage and debridement of empyema, and four had a biopsy of a mediastinal lymph node. In addition, three patients had a partial pleurectomy for secondary pneumothorax, one underwent a biopsy of a mediastinal mass, and one had a hematoma removed. Furthermore, a foreign body was extracted from one patient, and a wedge resection for the diagnosis of multiple lung nodules was performed on another. None of the patients required a thoracotomy. Morbidity was observed in three patients (9%), but no mortality was seen.

Conclusion: Thoracoscopy performed under local anesthesia and sedation is a safe and effective, even for patients in poor general condition.

Keywords : Local anesthesia; medical thoracoscopy; pleural effusion; video-assisted thoracoscopy
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