Analysis of therapeutic effect of single-hole VATS under non-intubated thoracoscopic surgery epidural anesthesia in the treatment of non-small cell lung cancer
- VernacularTitle:自主呼吸非气管插管硬膜外麻醉下单孔胸腔镜手术治疗非小细胞肺癌的疗效分析
- Author:
Ming DING
1
;
Guoxiang RONG
1
;
Zhongjun PAN
1
Author Information
- Publication Type:Journal Article
- Keywords: carcinoma,non-small-cell lung; anesthesia,epidural; non-tracheal intubation; single-hole video-assisted thoracic surgery; opioid
- From: Tianjin Medical Journal 2025;53(4):411-415
- CountryChina
- Language:Chinese
- Abstract: Objective To investigate the efficacy and safety of non-intubated thoracoscopic surgery in the treatment of non-small cell lung cancer(NSCLC).Methods A total of 180 NSCLC patients were selected and matched by propensity score proximity matching method.Patients were divided into the group A,the group B,the group C and the group D,with 45 cases each.Patients in the group A underwent non-intubated thoracoscopic surgery epidural anesthesia with single operation hole operation,the group B underwent non-intubated thoracoscopic surgery epidural anesthesia with three operation holes,the group C underwent double-cavity tracheal intubation with general anesthesia with single operation hole operation and the group D underwent double-cavity tracheal intubation with three operation holes under general anesthesia.Anesthesia related indexes,surgical related indexes,CD3+,CD4+,CD4+/CD8+,1-second forced expiratory volume(FEV1),maximal voluntary ventilation(MVV),forced vital capacity(FVC)and complication rate of the 4 groups were compared 1 day before surgery and 1 month after surgery.Results The anesthetic preparation time,first anal exhaust time and first getting out of bed time were shorter in the group A and the group B than those in the group C and the group D,and the dosage of propofol and remifentanil was lower in the group A and the group B than that in the group C and the group D(P＜0.05).Compared with the other 3 groups,the group A had the shortest postoperative drainage and hospital stay,and the highest CD3+,CD4+,CD4+/CD8+and FEV1,FVC and MVV at 1 month after surgery(P＜0.05).One month after surgery,CD3+,CD4+,CD4+/CD8+,FEV1,FVC and MVV were lower than 1 day before surgery in the 4 groups.The total incidence of postoperative complications was lower in the group A than that of the other 3 groups(P＜0.05).Conclusion Non-intubated thoracoscopic surgery with epidural anesthesia and single operation hole can improve the clinical efficacy of NSCLC patients,reduce the dosage of opioids and have good safety.
