Non-intubated combined with video-assisted thoracoscopic in carinal reconstruction

Peng, Guilin; Cui, Fei; Ang, Keng Leong; Zhang, Xin; Yin, Weiqiang; Shao, Wenlong; Dong, Qi; Liang, Lixia; He, Jianxing

doi:10.21037/jtd.2016.01.58

Cited by 40 publications

(32 citation statements)

References 10 publications

(5 reference statements)

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“…Non-intubated procedures have been progressively reintroduced in the clinical practice and proved feasible and safe (1,10,15,(19)(20)(21)(22)(23). Combination of non-intubated surgery under SI-VATS for pulmonary resections was first described by Rocco in 2010 (8), and then some series have been published (1,10).…”

Section: Discussionmentioning

confidence: 99%

Non-intubated single-incision video-assisted thoracic surgery: a two-center cohort of 188 patients

et al. 2017

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Background: Non-intubated single-incision procedures are slowly expanding because of high experience and skill required, and stricter selection criteria. The aim of this study is to present the first retrospective two-center series in Taiwan and Spain.Methods: We performed a retrospective analysis of 188 patients undergoing non-intubated single-incision video-assisted thoracic surgery (NI-SI-VATS) procedures between July 2013 to November 2015 in two centers in Taiwan (170 patients) and Spain (18 patients) with two different anesthetic methods. Demographic data, clinicopathological features, preoperative tests, and final outcomes were analyzed to compare the outcomes with the two different techniques.Results: Of the 188 patients, 147 (78%) were women, with a mean body mass index (BMI) of 22.7. Of the 196 specimens, 145 (74%) were malignancies with a mean size of 9.7 mm. Wedge resection was performed in 172 patients (91.4%), anatomical segmentectomy with lymphadenectomy in 8 (4.7%), and lobectomy with lymphadenectomy in 5 (2.6%). Three patients (1.6%) required conversion to orotracheal intubation, while 5 patients (2.7%) required additional ports. Complications appeared in 16 patients (8.5%) with air leak as the most frequent in 7 cases (3.7%). Median chest drainage was 1 day, and median postoperative stay was 3 days.There was neither perioperative death nor postoperative readmission.Conclusions: Non-intubated single-incision procedures can be feasible and safe in expert hands and experienced teams, even for anatomical resections. Strict selection criteria, skill and experience are mandatory. Comparative cohorts and randomized trials are needed.

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Section: Discussionmentioning

confidence: 99%

Non-intubated single-incision video-assisted thoracic surgery: a two-center cohort of 188 patients

et al. 2017

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“…Although initially not considered appropriate for major anatomical resections such as lobectomies or anatomical segmentectomies, a great advance has been made in this field so nowadays these procedures are routinely practiced in several units of Thoracic Surgery and even more complex anatomical resections have been attempted (2,3).…”

Section: Introductionmentioning

confidence: 99%

Nonintubated uniportal VATS pulmonary anatomical resections

Gálvez¹,

Navarro-Martínez²,

Bolufer³

et al. 2017

J. Vis. Surg.

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Reasons why and historical perspective M a j o r a n a t o m i c a l r e s e c t i o n s ( s e g m e n t e c t o m i e s , Some concerns about regional analgesia, vagal block for cough reflex control and oxygenation techniques, combined with some specific surgical tips can make safer these procedures. Specialists must remember an essential global concept: all the efforts are aimed at decreasing the invasiveness of the whole procedure in order to benefit patients' intraoperative status and postoperative recovery.

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“…On the other hand, there is very little evidence about the oncological outcomes regarding on the hypothetical minor alteration of the antitumor immune response. Indications of non-intubated lung-preserving resections are continuously growing as the most innovative surgical teams develop more and more procedures under safety conditions with excellent results (15).…”

Section: Discussionmentioning

confidence: 99%

Non-intubated uniportal left-lower lobe upper segmentectomy (S6)

et al. 2017

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Worldwide accepted indications of anatomical segmentectomies are mainly early stage primary adenocarcinomas, pulmonary metastasis and benign conditions. Their performance through uniportal VATS has become more and more popular due to the less invasiveness of the whole procedure under this approach. Recently, many efforts have focused on non-intubated spontaneously breathing management of lobectomies and anatomical segmentectomies, although specific selection criteria and main advantages are not completely standardized. In a 62-year-old thin man with two pulmonary residual metastasis from sigma adenocarcinoma, after chemotherapy plus antiangiogenic treatment, we indicated a single-incision videoassisted left-lower lobe (LLL) upper segmentectomy (S6) under spontaneous breathing and intercostal blockade. Total operation time was 240 minutes. Chest tube was removed at 24 hours and the patient was discharge on postoperative day 2 without any complication. Non-intubated uniportal VATS is a safe and reasonable approach for lung-sparing resections in selected patients, although more evidence is required for selecting which patients can benefit more over standard intubated procedures.

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Non-intubated combined with video-assisted thoracoscopic in carinal reconstruction

Cited by 40 publications

References 10 publications

Non-intubated single-incision video-assisted thoracic surgery: a two-center cohort of 188 patients

Non-intubated single-incision video-assisted thoracic surgery: a two-center cohort of 188 patients

Nonintubated uniportal VATS pulmonary anatomical resections

Non-intubated uniportal left-lower lobe upper segmentectomy (S6)

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