Nonintubated Uniportal Video-Assisted Thoracoscopic Surgery: A Single-Center Experience.
10.5090/kjtcs.2018.51.5.344
- Author:
Seha AHN
1
;
Youngkyu MOON
;
Zeead M. ALGHAMDI
;
Sook Whan SUNG
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Korea. swsung@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Nonintubated;
Uniportal;
Thoracic surgery;
Minimally invasive surgical procedures
- MeSH:
Anesthesia;
Anesthesia, Local;
Anoxia;
Arteries;
Chest Tubes;
Chylothorax;
Hospital Mortality;
Humans;
Intercostal Nerves;
Intubation;
Ion Transport*;
Length of Stay;
Lung Diseases;
Lung Neoplasms;
Mastectomy, Segmental;
Minimally Invasive Surgical Procedures;
Neoplasm Metastasis;
Pleural Diseases;
Pleural Effusion;
Pneumonia;
Thoracic Surgery;
Thoracic Surgery, Video-Assisted*
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2018;51(5):344-349
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: We report our surgical technique for nonintubated uniportal video-assisted thoracoscopic surgery (VATS) pulmonary resection and early postoperative outcomes at a single center. METHODS: Between January and July 2017, 40 consecutive patients underwent nonintubated uniportal VATS pulmonary resection. Multilevel intercostal nerve block was performed using local anesthesia in all patients, and an intrathoracic vagal blockade was performed in 35 patients (87.5%). RESULTS: Twenty-nine procedures (72.5%) were performed in patients with lung cancer (21 lobectomies, 6 segmentectomies, and 2 wedge resections), and 11 (27.5%) in patients with pulmonary metastases, benign lung disease, or pleural disease. The mean anesthesia time was 166.8 minutes, and the mean operative duration was 125.9 minutes. The mean postoperative chest tube duration was 3.2 days, and the mean hospital stay was 5.8 days. There were 3 conversions (7.5%) to intubation due to intraoperative hypoxemia and 1 conversion (2.5%) to multiportal VATS due to injury of the segmental artery. There were 7 complications (17.5%), including 3 cases of prolonged air leak, 2 cases of chylothorax, 1 case of pleural effusion, and 1 case of pneumonia. There was no in-hospital mortality. CONCLUSION: Nonintubated uniportal VATS appears to be a feasible and valid surgical option, depending on the surgeon’s experience, for appropriately selected patients.
