Video-assisted thoracoscopic surgery (VATS) is a minimally invasive surgical procedure, used to diagnose and treat illness or injury to the lung and other organs in thorax . However, 26.5 % required two procedures, 5 ... Pleural effusions secondary to trapped lung will tend to recur and drainage is warranted only if the patient is symptomatic . 3. Patients may … VATS provides adequate visualization despite limited access to the thorax, allowing the procedure to be performed in a state of debilitation and for patients who have marginal pulmonary reserve. Thoracotomy: A thoracotomy is a more invasive procedure than VATS. Exudate pleural effusion can be caused by malignancy (cancer) or lung infection. The Institutional Review Board of Swedish Medical Center approved this study and waived the requirement for informed consent owing to the study’s retrospective nature. To treat various lung conditions such as fluid accumulating in the lining of the lung (pleural effusion). Introduction. Pleurodesis is a procedure to adhere your lungs to your chest wall. In many cases this is indicated for an undiagnosed pleural effusion, in which the cytology is inconclusive. We report our experience from a single institution with the use of video-assisted thoracoscopic surgery (VATS) in the management of malignant effusions. 15% of pleural effusions remains undiagnosed. Diagnostic Procedures With VATS, diagnosis of pleural disease, thoracentesis, and pleural biopsy of a specific area under direct vision can be performed. Doctors may recommend the procedure if patients have an infection within the pleural cavity. This allows a quick and full recovery, which is essential if there is underlying malignancy and patient will require further oncological treatment. Jacobeus used the cystoscope in 1910 to first visualize the pleural cavity. VATS is indicated for diagnosing pleural effusions that have remained undiagnosed despite previous, less invasive tests (e.g., thoracentesis). Likewise, a suspicious effusion which results in VATS pleural biopsy can be converted to pleurodesis when frozen section reveal inflammatory disease. Pleural effusion is a buildup of fluid in the chest or on the lungs. Video-assisted thoracic surgery (VATS) has assumed greater importance in the management of pleural disease. pleural effusions; therefore, complete obliteration of the pleural space appears to be the procedure of choice [2]. Removing lymph nodes. During the 19th century, pleural effusion was managed primarily via open thoracic drainage, until 1876, when closed tube drainage was first described. Anterior Mediastinotomy (Chamberlain Procedure) Enough biopsy material is obtained to send for frozen section and permanent pathologic analysis as well as flow cytometry etc. A pleural effusion is the build-up of excess fluid between the layers of the pleura – the thin membrane that lines the outside of the lungs and the inside of the chest cavity. A bronchoscopy or video-assisted thoracic surgery (VATS) may be used. Video-assisted thoracoscopic surgery (VATS): VATS is often used for malignant pleural effusions. Causes of transudate pleural effusion include congestive heart failure, kidney failure, and cirrhosis. Thoracentesis uses imaging guidance and a needle to help diagnose and treat pleural effusions, a condition in which the space between the lungs and the inside of the chest wall contains excess fluid. We explain the procedure, the recovery process, and its potential complications. Typically, transudate pleural effusion is more easily treatable. The procedures currently available for the diagnosis and treatment of pleural effusions include thoracentesis, closed pleural biopsies, image-guided pleural biopsies (ultrasound or CT-guided), pleuroscopy and video-assisted thoracic surgery (VATS). 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