Contraindications of video-assisted thoracoscopic surgery for esophageal cancer

With the rapid development of medical technology, the treatment methods of esophageal cancer have also become diversified. Video-assisted thoracoscopic surgery is an emerging method that can be used to treat esophageal cancer. It is a thoracoscopic surgery equipped with modern television camera technology and high-tech surgical instruments. Only a small incision is needed to complete the operation. However, thoracoscopic surgery also has contraindications, which need to be strictly followed to ensure the success rate of the operation.

1. Those with severe functional impairment

Patients with severe organ damage, especially severe lung damage, need to be selected with caution. For example, patients with CO2 partial pressure ≥ 55 mmHg, or ventilation reserve less than 60%, or FEV1 measured value less than 1000 ml, and those who cannot tolerate single-lung ventilation during surgery are not suitable for thoracoscopic surgery, otherwise they are prone to respiratory failure after surgery and endanger their lives.

2. Patients with severe heart disease

If the patient has a history of heart failure, or is in a state of heart failure, unstable angina, a history of myocardial infarction in the past 3 months, severe arrhythmia such as frequent ventricular premature beats, and heart failure caused by various reasons reaching level 3 or above, these patients are temporarily not suitable for surgery and should first receive active internal medicine treatment and consider surgery after their condition stabilizes.

3. Those with a history of chest infection

Patients with a history of ipsilateral chest surgery or chest infection, especially those who have undergone pleurodesis or have severe pleural hypertrophy and adhesions, are strictly prohibited from undergoing thoracoscopic surgery.

4. Transfer has occurred

Surgery is contraindicated for patients with esophageal cancer that has obviously invaded surrounding important organs, has lymph node metastasis, or has metastasized to other organs such as the liver, lungs, and bones.

5. Others

Patients have airway hyperresponsiveness diseases such as asthma, bronchiectasis, purulent bronchitis, etc.