Procedural times in early non-intubated VATS program - a propensity score analysis.

Female Germany Humans Male Middle Aged Operative Time Propensity Score Retrospective Studies Thoracic Surgery, Video-Assisted / methods
Non-intubated VATS Procedural times Spontaneous ventilation VATS Video-assisted thoracoscopic surgery

Journal

BMC anesthesiology
ISSN: 1471-2253
Titre abrégé: BMC Anesthesiol
Pays: England
ID NLM: 100968535

Informations de publication

Date de publication:
11 02 2021
Historique:
received: 17 09 2020
accepted: 04 02 2021
entrez: 12 2 2021
pubmed: 13 2 2021
medline: 15 12 2021
Statut: epublish

Résumé

Non-intubated video-assisted thoracic surgery (NiVATS) has been introduced to surgical medicine in order to reduce the invasiveness of anesthetic procedures and avoid adverse effects of intubation and one-lung ventilation (OLV). The aim of this study is to determine the time effectiveness of a NiVATS program compared to conventional OLV. This retrospective analysis included all patients in Leipzig University Hospital that needed minor VATS surgery between November 2016 and October 2019 constituting a NiVATS (n = 67) and an OLV (n = 36) group. Perioperative data was matched via propensity score analysis, identifying two comparable groups with 23 patients. Matched pairs were compared via t-Test. Patients in NiVATS and OLV group show no significant differences other than the type of surgical procedure performed. Wedge resection was performed significantly more often under NiVATS conditions than with OLV (p = 0,043). Recovery time was significantly reduced by 7 min (p = 0,000) in the NiVATS group. There was no significant difference in the time for induction of anesthesia, duration of surgical procedure or overall procedural time. Recovery time was significantly shorter in NiVATS, but this effect disappeared when extrapolated to total procedural time. Even during the implementation phase of NiVATS programs, no extension of procedural times occurs.

Sections du résumé

BACKGROUND
Non-intubated video-assisted thoracic surgery (NiVATS) has been introduced to surgical medicine in order to reduce the invasiveness of anesthetic procedures and avoid adverse effects of intubation and one-lung ventilation (OLV). The aim of this study is to determine the time effectiveness of a NiVATS program compared to conventional OLV.
METHODS
This retrospective analysis included all patients in Leipzig University Hospital that needed minor VATS surgery between November 2016 and October 2019 constituting a NiVATS (n = 67) and an OLV (n = 36) group. Perioperative data was matched via propensity score analysis, identifying two comparable groups with 23 patients. Matched pairs were compared via t-Test.
RESULTS
Patients in NiVATS and OLV group show no significant differences other than the type of surgical procedure performed. Wedge resection was performed significantly more often under NiVATS conditions than with OLV (p = 0,043). Recovery time was significantly reduced by 7 min (p = 0,000) in the NiVATS group. There was no significant difference in the time for induction of anesthesia, duration of surgical procedure or overall procedural time.
CONCLUSIONS
Recovery time was significantly shorter in NiVATS, but this effect disappeared when extrapolated to total procedural time. Even during the implementation phase of NiVATS programs, no extension of procedural times occurs.

Identifiants

DOI: 10.1186/s12871-021-01270-4 PMID: 33573604 PMC: PMC7877094
pubmed: 33573604
doi: 10.1186/s12871-021-01270-4
pii: 10.1186/s12871-021-01270-4
pmc: PMC7877094
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

44

Références

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pubmed: 27658473 pmcid: 5963493

Auteurs

Isabella Metelmann (I)

Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany. Isabella.metelmann@medizin.uni-leipzig.de.

Johannes Broschewitz (J)

Department of General, Visceral, Thoracic and Vascular Surgery, Faculty of Health Sciences Brandenburg, Brandenburg Medical School, University Hospital Neuruppin, Fehrbelliner Strasse 38, 16816, Neuruppin, Germany.

Uta-Carolin Pietsch (UC)

Department of Anesthesiology and Intensive Care Medicine, University Hospital of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.

Gerald Huschak (G)

Department of Anesthesiology and Intensive Care Medicine, University Hospital of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.
OR Management, University Hospital of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.

Uwe Eichfeld (U)

Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.

Sven Bercker (S)

Department of Anesthesiology and Intensive Care Medicine, University Hospital of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.

Sebastian Kraemer (S)

Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.

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questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie thoracique › Thoracoscopie › Chirurgie thoracique vidéoassistée › Procedural times in early non-intubated VATS...