Thoracoscopy in pleural effusion - two techniques: awake single-access video-assisted thoracic surgery versus 2-ports video-assisted thoracic surgery under general anesthesia.

Awake single access video-assisted thoracic surgery with local anesthesia improves procedure tolerance, reduces postoperative stay and costs. Materials & methods: Local anesthesia was made with lidocaine and ropivacaine. We realize one 20 mm incision for the single-access', and two incisions for the 2-trocars technique'. Results: Mortality rate was 0% in both groups. Postoperative stay: 3dd +/- 4 versus 4dd +/- 5, mean operative time: 39 min versus 37 min (p < 0.05). Chest tube duration: 2dd +/- 5 versus 3dd +/- 6. Complications: 11/95 versus 10/79. Conclusion: Awake technique reduce postoperative hospital stay and chest drainage duration, similar complications and recurrence rate. The authors can say that awake single-access VATS' is an optimal diagnostic and therapeutic tool for the management of pleural effusions, but above extends surgical indication to high-risk patients.