Video-assisted thoracoscopy is feasible under local anesthesia

Abstract

Video-assisted thoracoscopy (VAT) is usually performed under general anesthesia (GA). We performed an analysis to determine whether multithoracoport VAT under local anesthesia (LA) is feasible. Methods: Forty-five VAT under LA were performed in 34 men and 11 women (mean age 46.8 years) in the endoscopy room. Results: The waiting time for VAT under LA was 0.5-6 h on working days. There were no major complications during or after the VAT. In 9 patients, pleural malignancy was diagnosed, and in 7 patients suspected malignancy was excluded. In 5 patients we found bacterial empyema, of whom 4 had diathermic adhesiolysis during VAT. In 4 patients, the clinical diagnosis was tuberculosis by exclusion, and in 2 patients no conclusive diagnosis could be drawn. VAT influenced treatment policy 15 times, and in 17 pneumothorax patients talc poudrage was performed during the procedure. Conclusion: VAT under LA is safe, effective, logistically simple, and requires no long waiting times. No conversion to GA was necessary.