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- W4386546671 abstract ": Intraoperative bleeding is the most feared and challenging complication during uniportal video-assisted thoracic surgery (VATS) major resections due to the specific features of pulmonary circulation and the intrinsic limitations of a unique small incision approach. Despite infrequently reported in uniportal VATS series, its real incidence is probably under-reported due to the lack of uniportal VATS multicentric databases and registries, and also that many can be safely managed and remain unknown. Prevention through training and simulation, experience in uniportal VATS approach and technological advances that decrease the risk of vascular injury, are cornerstones. But as vascular injury is preventable but not absolutely avoidable, preparation should a vascular injury occurs allows a secure resolution in most cases, and mainly relies on pulmonary artery (PA) control in moderate-high risk cases before dissection during challenging stages of the procedure, usually related to calcified or tumoral lymph nodes or central tumors in relation to PA or branches. Different techniques depending on the severity degree can be applied through uniportal VATS, from direct compression through uniportal VATS under video-assistance, to application of sealants, hemostatics and patches for minor tears. In addition, the safe utilization of vascular endostaplers or endoclips, or even the performance of PA control and angiography, can avoid conversion to open thoracotomy, but in some specific situations it should not be delayed, and its quick and safe performance must be known and trained." @default.
- W4386546671 created "2023-09-09" @default.
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- W4386546671 date "2023-09-01" @default.
- W4386546671 modified "2023-10-16" @default.
- W4386546671 title "Bleeding control during uniportal video-assisted thoracic surgery without conversion: evidence and technical aspects" @default.
- W4386546671 doi "https://doi.org/10.21037/vats-23-1" @default.
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