Nonintubated uniportal thoracoscopic segmentectomy for lung cancer.
Nonintubated anesthesia
Thoracic surgery
Uniportal VATS
VATS segmentectomy
Video-assisted thoracic surgery
Journal
Journal of the Formosan Medical Association = Taiwan yi zhi
ISSN: 0929-6646
Titre abrégé: J Formos Med Assoc
Pays: Singapore
ID NLM: 9214933
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
22
09
2019
revised:
25
02
2020
accepted:
23
03
2020
pubmed:
19
4
2020
medline:
20
2
2021
entrez:
19
4
2020
Statut:
ppublish
Résumé
Uniportal thoracoscopic segmentectomy under intubated general anesthesia with one-lung ventilation has recently been introduced for the management of lung cancer patients with small tumors or compromised cardiopulmonary function. However, uniportal thoracoscopic segmentectomy without endotracheal intubation had rarely been performed. Therefore, in this study, we aimed to evaluate the feasibility and safety of this novel technique. From January 2014 to November 2018, 32 lung cancer patients were treated using nonintubated uniportal thoracoscopic segmentectomy under a combination of target-controlled infusion of propofol, nasal high-flow oxygen therapy, intrathoracic intercostal nerve blockade, and vagal nerve blockade. Sixty-two other lung cancer patients who underwent initial planning nonintubated multiportal thoracoscopic segmentectomy during the same period were included as the control group. Preoperative dye localization was required in 18 (56.3%) patients of uniportal group. No patients required conversion to tracheal intubation or thoracotomy. Two patients were converted from the one-port to the two-port approach due to severe adhesions in the pleural cavity. The mean durations of anesthetic induction and surgery were 12.7 min and 101.1 min, respectively. Postoperative complications were noted in two patients (2/32, 6.3%) of uniportal group: one had subcutaneous emphysema and the other had prolonged air leaks over 3 days. The median durations of postoperative chest drainage and hospital stay were 1 and 3 days in uniportal group, respectively. Nonintubated uniportal thoracoscopic segmentectomy is technically feasible and safe for selected patients. It can be an attractive alternative to intubated thoracoscopic segmentectomy for patients with early lung cancer.
Sections du résumé
BACKGROUND AND OBJECTIVES
OBJECTIVE
Uniportal thoracoscopic segmentectomy under intubated general anesthesia with one-lung ventilation has recently been introduced for the management of lung cancer patients with small tumors or compromised cardiopulmonary function. However, uniportal thoracoscopic segmentectomy without endotracheal intubation had rarely been performed. Therefore, in this study, we aimed to evaluate the feasibility and safety of this novel technique.
METHODS
METHODS
From January 2014 to November 2018, 32 lung cancer patients were treated using nonintubated uniportal thoracoscopic segmentectomy under a combination of target-controlled infusion of propofol, nasal high-flow oxygen therapy, intrathoracic intercostal nerve blockade, and vagal nerve blockade. Sixty-two other lung cancer patients who underwent initial planning nonintubated multiportal thoracoscopic segmentectomy during the same period were included as the control group.
RESULTS
RESULTS
Preoperative dye localization was required in 18 (56.3%) patients of uniportal group. No patients required conversion to tracheal intubation or thoracotomy. Two patients were converted from the one-port to the two-port approach due to severe adhesions in the pleural cavity. The mean durations of anesthetic induction and surgery were 12.7 min and 101.1 min, respectively. Postoperative complications were noted in two patients (2/32, 6.3%) of uniportal group: one had subcutaneous emphysema and the other had prolonged air leaks over 3 days. The median durations of postoperative chest drainage and hospital stay were 1 and 3 days in uniportal group, respectively.
CONCLUSION
CONCLUSIONS
Nonintubated uniportal thoracoscopic segmentectomy is technically feasible and safe for selected patients. It can be an attractive alternative to intubated thoracoscopic segmentectomy for patients with early lung cancer.
Identifiants
pubmed: 32303399
pii: S0929-6646(20)30115-7
doi: 10.1016/j.jfma.2020.03.021
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1396-1404Informations de copyright
Copyright © 2020. Published by Elsevier B.V.