Spontaneous versus mechanical ventilation during video-assisted thoracoscopic surgery for spontaneous pneumothorax: A randomized trial

Li, Jun; Liang, Hengrui; Cui, Fei; Liu, Hui; Zhu, Chengchu; Liang, Wenhua; He, Jianxing; Wang, Wei; Jiang, Shunjun; Dong, Qi; Liang, Lixia; Yang, Hanyu; Li, Yingfen; Jin, Jianhua; Shen, Jianfei; Dai, Tianyang; He, Kaiming; Cai, Kaican; Feng, Siyang; Wang, Haofei; Zhang, Zhifeng; Huang, Haoda; Cheng, Chao; Liu, Zhenguo; Qiao, Kun; Xia, Zhaohua; Liu, Xiang; Wang, Guangsuo; Huang, Tonghai; Xu, Shun; Shen, Qiming; Tan, Wen-Fei; Ding, Jinfeng; Liu, Yulin; Ye, Jing; Jiang, Yu; Zhang, Huangkai; Feng, Xia; Ma, Mingfei; Duan, Zhongxin; Li, Yali; Ma, Hong; Ng, Calvin S.H.; González-Rivas, Diego; Pompeo, Eugenio; Daley, Erlin; Flores, Raja M.; Shargall, Yaron; Ismail, Mahmoud; Ang, Keng‐Leong; Ambrogi, Vincenzo; Elkhouly, Ahmed

doi:10.1016/j.jtcvs.2021.01.093

Cited by 17 publications

(21 citation statements)

References 33 publications

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“…All procedures and consumption of anesthesia were described in the previous study (18,20,21). Briefly, tracheal intubation ventilation was not administered throughout the operation under the SV-VATS.…”

Section: Anesthesia and Surgical Managementmentioning

confidence: 99%

“…Because of the relatively unstable operation field and moving of mediastinal structures, some researchers may question whether the systematic lymph node dissection under the SV-VATS is eligible and long-term outcomes compared to MV-VATS (11). It was hypothesized that the longterm outcomes of the SV-VATS was not inferior to or even better than the MV-VATS according to the better perioperative outcomes, with less opioid use and less inflammatory response (18,19).…”

Section: Introductionmentioning

confidence: 99%

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Perioperative and long-term outcomes of spontaneous ventilation video-assisted thoracoscopic surgery for non-small cell lung cancer

Zheng¹,

Liang²,

Wang³

et al. 2021

Transl Lung Cancer Res

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Background: Spontaneous ventilation video-assisted thoracoscopic surgery (SV-VATS) exhibits dual intraoperative and postoperative advantages for patients with non-small cell lung cancer (NSCLC).However, there is a lack of data regarding its long-term survival superiority over the double-lumen intubated mechanical ventilation video-assisted thoracoscopic surgery (MV-VATS) or thoracotomy.Methods: A retrospective study was conducted from 2011 to 2018 in the First Affiliated Hospital of Guangzhou Medical University among patients with NSCLC who underwent the SV-VATS or the MV-VATS. Patients receiving the SV-VATS were the study group, and patients receiving the MV-VATS were the control group. Propensity score matching (PSM) was performed to establish 1:1 SV-VATS versus MV-VATS group matching to balance potential baseline confounding factors. Primary endpoints were overall survival (OS) and disease-free survival (DFS). Secondary endpoints were perioperative outcomes. The baseline information of these patients was recorded. The perioperative data and survival data were collected using a combination of electronic data record system and telephone interview. A 1:1:1 SPM was also used to compare the OS in the SV-VATS, the MV-VATS and thoracotomy group by using another database, including patients undergoing thoracotomy and the MV-VATS.Results: For the two-group comparison, after 1:1 PSM, a matched cohort with 400 (200:200) patients was generated. The median follow-up time in this cohort was 4.78 years (IQR, 3.78-6.62 years). The OS (HR =0.567, 95% CI, 0.330 to 0.974, P=0.0498) and the DFS (HR =0.546, 95% CI, 0.346 to 0.863, P=0.013) of the SV-VATS group were significantly better than the MV-VATS group. There were no statistically differences between the SV-VATS and the MV-VATS group on the operative time (158.56±40.09 vs.

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Section: Anesthesia and Surgical Managementmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Perioperative and long-term outcomes of spontaneous ventilation video-assisted thoracoscopic surgery for non-small cell lung cancer

Zheng¹,

Liang²,

Wang³

et al. 2021

Transl Lung Cancer Res

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“…At present, the range of applications of tubeless general anesthesia reported in studies ranges from simple lung biopsy, bullae resection, and palmar hyperhidrosis to pulmonary wedge, lobectomy, segmentectomy, mediastinal tumors, even difficult tracheal tumor resection and augmentation reconstruction; the surgical approach ranges from porous to single‐hole, from common to da Vinci robotic surgery. Jinshing Chen's team in Taiwan and Jianxing He's team in the First Affiliated Hospital of Guangzhou Medical University carried out and continuously promoted this technology respectively 6–8 9 …”

Section: Discussionmentioning

confidence: 99%

“…Jinshing Chen's team in Taiwan and Jianxing He's team in the First Affiliated Hospital of Guangzhou Medical University carried out and continuously promoted this technology respectively. [6][7][8] Tubeless anesthesia is also in line with the current concept of fast-track surgery(ERAS). 9 In this study, we retrospectively analyzed the case data of 100 patients to evaluate the advantages and safety of non-intubated anesthesia.…”

Section: E335mentioning

confidence: 99%

Clinical application of preserving spontaneous breathing non‐intubation anesthesia in thoracoscopic surgery for lung cancer under ERAS concept

Chen

Luo

et al. 2021

Asia-Pac J Clncl Oncology

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Objective: To explore the safety and feasibility of thoracoscopic surgery in patients with lung cancer under non-intubation anesthesia, and to evaluate the advantages of the non-intubation anesthesia compared with intubation anesthesia on enhanced recovery after surgery (ERAS). Methods: A retrospective cohort study was conducted in which 100 patients who underwent thoracoscopic lung cancer surgery from January 2020 to February 2021 in the Department of Thoracic Surgery of the First Affiliated Hospital of Soochow University were included and divided into non-intubation group (n = 50) and intubation group (n = 50). The primary outcome was the comparison of intra-and postoperative parameters. Secondary outcomes included inflammatory response indicators and intra-and postoperative complications.Results: There was no significant difference between the two groups in anesthesia effect score, blood loss, lowest pulse oxygen saturation, operation time, postoperative chest tube indwelling time (P > 0.05). Non-intubation group had less intraoperative remifentanil dosage, less change of blood pressure and heart rate, lower postoperative pain numerical score(NRS), less medical costs, smaller incidence rate of throat discomfort (P < 0.05). The non-intubation group was also associated with less extubation time, postanesthesia care unit recovery time, ambulation time, food intake time, postoperative antibiotic use time, and hospital stay (P < 0.05). The increase of C-reactive protein in the non-intubation group was lower than that in the intubation group (P < 0.05). Conclusion:Non-intubation anesthesia for thoracoscopic lung cancer surgery is safe and feasible. Compared with the intubation anesthesia, it has advantages in ERAS and reducing medical costs.

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“…Spontaneous ventilation video-assisted thoracoscopic surgery (SV-VATS) has developed rapidly recently and achieved promising results (11). According to the reports, SV-VATS can reduce the perioperative adverse effects of tracheal intubation and general anesthesia in thoracic surgery (12)(13)(14) and provide more comfortable surgical experience for NSCLC patients. Therefore, SV-VATS has become a viable alternative to various thoracic surgeries (15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

Spontaneous Ventilation Video-Assisted Thoracoscopic Surgery for Non-small-cell Lung Cancer Patients With Poor Lung Function: Short- and Long-Term Outcomes

Wang

Jiang

et al. 2022

Front. Surg.

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ObjectiveThe goal of this study was to explore the feasibility and safety of spontaneous ventilation video-assisted thoracoscopic surgery (SV-VATS) for non-small-cell lung cancer (NSCLC) patients with poor lung function.MethodsNSCLC patients with poor lung function who underwent SV-VATS or mechanical ventilation VATS (MV-VATS) from 2011 to 2018 were analyzed. 1:2 Propensity score matching (PSM) was applied, and the short- and long-term outcomes between the SV-VATS group and the MV-VATS group were compared.ResultsAnesthesia time (226.18 ± 64.89 min vs. 248.27 ± 76.07 min; P = 0.03), operative time (140.85 ± 76.07 min vs. 163.12 ± 69.37 min; P = 0.01), days of postoperative hospitalization (7.29 ± 3.35 days vs. 8.40 ± 7.89 days; P = 0.04), and days of chest tube use (4.15 ± 2.89 days vs. 5.15 ± 3.54 days; P = 0.01), the number of N1 station lymph node dissection (2.94 ± 3.24 vs. 4.34 ± 4.15; P = 0.005) and systemic immune-inflammation index (3855.43 ± 3618.61 vs. 2908.11 ± 2933.89; P = 0.04) were lower in SV-VATS group. Overall survival and disease-free survival were not significantly different between the two groups (OS: HR 0.66, 95% CI: 0.41–1.07, P = 0.09; DFS: HR 0.78, 95% CI: 0.42–1.45, P = 0.43).ConclusionsComparable short-term and long-term outcomes indicated that SV-VATS is a feasible and safe method and might be an alternative to MV-VATS when managing NSCLC patients with poor lung function.

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Spontaneous versus mechanical ventilation during video-assisted thoracoscopic surgery for spontaneous pneumothorax: A randomized trial

Cited by 17 publications

References 33 publications

Perioperative and long-term outcomes of spontaneous ventilation video-assisted thoracoscopic surgery for non-small cell lung cancer

Perioperative and long-term outcomes of spontaneous ventilation video-assisted thoracoscopic surgery for non-small cell lung cancer

Clinical application of preserving spontaneous breathing non‐intubation anesthesia in thoracoscopic surgery for lung cancer under ERAS concept

Spontaneous Ventilation Video-Assisted Thoracoscopic Surgery for Non-small-cell Lung Cancer Patients With Poor Lung Function: Short- and Long-Term Outcomes

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