From 1993 to May 2001, 795 psychiatric patients were treated including 563 with
pleural effusion, 98 with multiple or solitary
tuberculoma, 69 with
tuberculous empyema, 14 with fibrotic-cavitary
tuberculosis, 51 with disseminated
tuberculosis. Mean age of the patients was 32 years. Survey of pleural cavity with pleural or lung biopsy was performed in 691 patients. In
tuberculoma 14 lobectomies were performed, 23 patients underwent atypical lung resection without stapler (including with precise technique). Bilateral on-stage interventions were made in 32 patients. In
empyema necrectomy and lung decortication were performed. 14 patients underwent videocavernoscopy with sequestrectomy and cavity drainage. In disseminated
tuberculosis lung biopsy without staplers was usually performed. Aerohemostasis was achieved with plasma stream. One patient with
empyema and one patient with
pleural effusion died (lethality was 0.25%). Rate of postoperative complications was 7.5% in
tuberculoma and 1.5% in disseminated
tuberculosis. Conversion to
thoracotomy was necessary in 3 (3%) patients with
tuberculoma and 12 (17%) patients with
empyema. Mean
hospital stay was 4 days after diagnostic surgery and 7 days after lung resection. In
pleural effusion diagnosis was verified in 98% cases, in disseminated
tuberculosis--in 100%. Videothoracoscopy is the best diagnostic method for
pleural effusion and disseminated forms of lung
tuberculosis and operation of choice in
tuberculoma and
empyema. Videothoracoscopy in
tuberculosis is highly effective and associates with low rate of postoperative complications and lethality.