Are postoperative pain and patient satisfaction influenced by the number of ports in VATS for malignant pleural effusion treatment?

Valchev, Daniel; Peeva, Katya; Petrov, Danail

doi:10.1080/00325481.2019.1697559

Cited by 3 publications

(3 citation statements)

References 11 publications

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“…The pain was statistically better controlled in the group subjected to MP than in Group B. The reasons for the reduction in pain are likely due to the minor invasiveness of MP, the smaller size of the instrument, and, consequently, the smaller thoracostomy access [ 33 ]. The ability to perform the procedure without orotracheal intubation drastically improves patient comfort and recovery time [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…The reasons for the reduction in pain are likely due to the minor invasiveness of MP, the smaller size of the instrument, and, consequently, the smaller thoracostomy access [ 33 ]. The ability to perform the procedure without orotracheal intubation drastically improves patient comfort and recovery time [ 33 ]. Performing a pleuroscopy under analgosedation and spontaneous breathing also allows the enrolment of patients with multiple comorbidities who would usually be excluded from more invasive procedures.…”

Section: Discussionmentioning

confidence: 99%

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Safety and Diagnostic Yield of Medical Pleuroscopy (MP) Performed under Balanced Analgosedation by a Pneumological Team Compared to Video-Assisted Thoracic Surgery (VATS): A Retrospective Controlled Real-Life Study (TORAPO)

Allocca,

Guidelli,

Galgano

et al. 2024

Diagnostics

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Introduction: Medical pleuroscopy (MP) is an invasive technique that provides access to the pleural space with a rigid or semi-rigid work instrument, allowing for visualization and the obtaining of bioptic pleural samples. Using pulmonologist-based analgosedation to perform pleuroscopy is still debated for safety reasons. The aim of this real-life study is to demonstrate the safety and diagnostic yield of MP performed under balanced analgosedation by a pulmonologist team with expertise in the management of critically ill patients in the respiratory intensive care unit (RICU) and interventional pulmonology unit as compared to video-assisted thoracic surgery (VATS) performed by a thoracic surgeon team under anesthesiologist-based analgosedation. Methods: In this multicentric retrospective controlled study, the inclusion criteria were patients older than 18 years old with pleural effusion of unknown diagnosis consecutively admitted in the years 2017–2022 to the pulmonology unit and RICU of San Donato Hospital in Arezzo (Italy, Tuscany) and to the thoracic surgery unit of Santa Maria Le Scotte in Siena (Italy, Tuscany) to undergo, respectively, MP under balanced propofol-based analgosedation on spontaneous breathing with local anesthesia provided by a pulmonologist team (Group A), and VATS provided by a surgeon team under propofol-based analgosedation managed by an anesthesiologist using invasive mechanical ventilation (IMV) via endotracheal intubation (ETI) (Group B). The primary endpoints were (1) a comparison between the two groups in terms of the diagnostic yield of pleural effusion, and (2) major and minor complications of pleuroscopic procedures. The secondary endpoints were (1) the length of the pleuroscopic procedure; (2) the duration of hospitalization; (3) propofol doses; and (4) the patient’s comfort after the procedure assessed using the Visual Analogue Scale (VAS). Results: We enrolled 91 patients in Group A and 116 patients in Group B. A conclusive diagnosis was obtained in 97.8% of Group A vs. 100% of Group B (p = 0.374). Malignant effusion was diagnosed in 59.3% of Group A and in 55.1% of Group B; p = 0.547. No intraoperative or postoperative mortality events or major complications were observed in Group A. The major complications observed in Group B were three major bleeding events (p = 0.079) and one exitus (p = 0.315) not related to the interventional procedure. No significant difference emerged between the two groups in terms of minor complications. The duration of the intervention was significantly lower in Group A (40.0 min ± 12.6 versus 51.5 ± 31.0; p = 0.001). Pain control and, therefore, patient comfort were better in Group A, with an average VAS of 0.34 ± 0.65 versus 2.58 ± 1.26, p < 0.001. The duration of hospitalization was lower in Group B (5.1 ± 2.6 vs. 15.5 ± 8.0, p < 0.001). The average overall dose of propofol administered was significantly lower in Group A (65.6 ± 35.8 mg versus 280 ± 20.0 mg; p < 0.001). Conclusions: This real-life study shows that the MP performed under propofol-based analgosedation by an independent pneumologist team is a safe and well-tolerated procedure with a diagnostic yield and complication rates similar to those obtained with VATS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Safety and Diagnostic Yield of Medical Pleuroscopy (MP) Performed under Balanced Analgosedation by a Pneumological Team Compared to Video-Assisted Thoracic Surgery (VATS): A Retrospective Controlled Real-Life Study (TORAPO)

Allocca,

Guidelli,

Galgano

et al. 2024

Diagnostics

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“…ve üç port karşılaştırması yapılmış ve ağrı kontrolü ve başarı açısından tek port ile yapılan tekniğin üstünlüğünden bahsedilmiştir(39). Dumanlı ve ark.…”

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Effectiveness of Vats in Pleural Diseases

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Sevilgen²

2021

SDÜ Tıp Fakültesi Dergisi

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Plevral hastalıklar klinikte karşımıza plevral kalınlaşma ve plevral efüzyon olarak çıkmaktadır. Plevral efüzyon, plevral boşlukta sıvı birikmesidir. Çalışmamızda, plevral efüzyon veya plevral kalınlaşma nedeni ile kliniğimize yatırdığımız ve Video Yardımlı Torakoskopik Cerrahi (VATS) yaptığımız hastaların klinik özelliklerini ve postoperatif patolojik sonuçlarını literatür bilgileri eşliğinde paylaşmayı amaçladık. Gereç ve Yöntem 2017 Ocak ile 2020 Ekim arasında plevral efüzyon ve plevral kalınlaşma nedeniyle Recep Tayyip Erdoğan Üniversitesi Eğitim Araştırma Hastanesi Göğüs Cerrahisi Kliniği'ne yatırılan ve VATS uygulanan 58 hastanın dosyaları retrospektif olarak incelendi. Hastaların yaş, cinsiyet, hastanede yatış süreleri belirlendi. Plevral sıvıların biyokimyasal testleri, sitolojileri, plevral biyopsi sonuçları ve hastanede yatış süreleri kaydedildi. Plevral biyopsilerin patolojileri malign ve benign olarak ayrılıp karşılaştırmalı olarak incelendi. Bulgular VATS ile biyopsi yapılan 58 hastanın 42'si (%72,4) erkek, 16'sı (%27,6) kadındı. Ortalama yaş 58,4 ±16,2 idi. Erkeklerin yaş ortalaması 58,2, kadınların yaş ortalaması ise 61,2 idi. Hastanede yatış süresi ortalama 4,1±1,4 gün idi. Hastaların 12'sinde (%20 ,6) plevral efüzyona eşlik eden plevral kalınlaşma mevcuttu. Plevral sıvı sitolojilerine bakıldığında 44 (%75,8) hastanın benign, 14 (%24,2) hastanın malign sitoloji olduğu görüldü. Biyopsi sonucu 17 (%29,3) hastada malign iken 41 (%70,7) hasta benign olarak değerlendirildi. Malign olarak sonuçlanan hastaların 11'i (%64,7) adenokarsinom idi. Benign sonuçların ise 29'u (%70,7) kronik aktif inflamasyon olarak sonuçlandı. SonuçAnalizlerimizin sonucunda, VATS'ın plevral hastalıkların tanı ve tedavisinde güvenle kullanılabilecek efektif minimal invaziv bir yöntem olduğunu düşünüyoruz.

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Exploring the Benefits of a Reduced-Port Approach in Robotic Posterior Retroperitoneoscopic Adrenalectomy: A Comparative Study of the Two-Port and Three-Port Techniques

Dashti,

Kim,

Lee

et al. 2024

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Are postoperative pain and patient satisfaction influenced by the number of ports in VATS for malignant pleural effusion treatment?

Cited by 3 publications

References 11 publications

Safety and Diagnostic Yield of Medical Pleuroscopy (MP) Performed under Balanced Analgosedation by a Pneumological Team Compared to Video-Assisted Thoracic Surgery (VATS): A Retrospective Controlled Real-Life Study (TORAPO)

Safety and Diagnostic Yield of Medical Pleuroscopy (MP) Performed under Balanced Analgosedation by a Pneumological Team Compared to Video-Assisted Thoracic Surgery (VATS): A Retrospective Controlled Real-Life Study (TORAPO)

Effectiveness of Vats in Pleural Diseases

Exploring the Benefits of a Reduced-Port Approach in Robotic Posterior Retroperitoneoscopic Adrenalectomy: A Comparative Study of the Two-Port and Three-Port Techniques

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