Fast-track video-assisted thoracoscopic surgery: future challenges

Scand Cardiovasc J. 2016;50(2):78-82. doi: 10.3109/14017431.2015.1114665. Epub 2015 Dec 1.


Objectives: To provide a short overview of fast-track video-assisted thoracoscopic surgery (VATS) and to identify areas requiring further research.

Design: A literature search was made using key words including: fast-track, enhanced recovery, video-assisted thoracoscopic surgery, robot-assisted thoracoscopic surgery (RATS), robotic, thoracotomy, single-incision, uniportal, natural orifice transluminal endoscopic surgery (NOTES), chest tube, air-leak, digital drainage, pain management, analgesia, perioperative management, anaesthesia and non-intubated. References from articles were screened for further articles. Using abstracts, areas of interest for developing a fast-track protocol were selected.

Results: The minimally invasive approach can be divided into several surgical methods that need further research to establish superiority. The role of intubation has to be further examined as well as the role of chest drains. Multimodal analgesic treatment including preoperative methylprednisolone seems promising and requires further research.

Conclusions: The fast-track data from other procedures may support future development and improvement of fast-track VATS.

Keywords: Analgesia; comorbidity; perioperative care; postoperative complications; robotic surgical procedures; video-assisted thoracoscopic surgery.

Publication types

  • Review

MeSH terms

  • Forecasting
  • Humans
  • Length of Stay
  • Pneumonectomy / adverse effects
  • Pneumonectomy / rehabilitation*
  • Pneumonectomy / trends
  • Postoperative Care / methods*
  • Postoperative Care / trends
  • Recovery of Function
  • Thoracic Surgery, Video-Assisted / adverse effects
  • Thoracic Surgery, Video-Assisted / rehabilitation*
  • Thoracic Surgery, Video-Assisted / trends
  • Time Factors
  • Treatment Outcome