Nonintubated Minimally Invasive Chest Wall Stabilization for Multiple Rib Fractures: a Prospective, Single-arm Study

Abstract

Background: Nonintubated video-assisted thoracoscopic surgery has been widely reported in the past decade, while nonintubated chest wall stabilization has not been reported previously. The aim of this study was to evaluate the safety and feasibility of nonintubated minimally invasive chest wall stabilization in patients with multiple rib fractures.Methods: We conducted a prospective, single-arm, observational study. In this prospective study, 20 consecutive patients with multiple rib fractures were treated using nonintubated minimally invasive chest wall stabilization.Results: Minimally invasive chest wall stabilization was mostly performed for lateral rib fractures in this study (n=8). The mean operation time was 92.5 minutes, and the mean blood loss was 49 ml. No patient required conversion to tracheal intubation. The mean extubation time of the laryngeal mask was 8.9 minutes; the mean postoperative fasting time was 6.1 hours; the mean postoperative hospital stay was 6.2 days; the mean amount of postoperative drainage was 97.5 ml; the mean postoperative pain score was 2.9 points at 6 hours, 2.8 points at 12 hours, and 3.0 points at 24 hours; and the mean postoperative nausea and vomiting score was 1.9 points at 6 hours, 1.8 points at 12 hours, and 1.7 points at 24 hours.Conclusions: Nonintubated minimally invasive chest wall stabilization is safe and feasible in carefully selected patients. Further studies with a large sample size are warranted.