SV-VATS exhibits dual intraoperative and postoperative advantages

Abstract

Background: The merits of spontaneous ventilation video-assisted thoracic surgery (SV-VATS) are still controversial. Our team retrospectively evaluated the intraoperative and postoperative advantages of this surgical approach, comparing with mechanical ventilation video-assisted thoracic surgery (MV-VATS).Methods: We did a single center retrospective study at the First Affiliated Hospital of Yunnan Province. 244 patients were eventually assigned to the SV-group and MV-group, and their intraoperative indicators and thoracic surgery postoperative data were included in the comparison. Results:The SV-group exhibited markedly less intraoperative bleeding and postoperative thoracic drainage, and the bleeding volume was correlated with the volume and duration of drainage. Further analysis showed that, patients undergoing SV-VATS had less activation of white blood cells and neutrophils after surgery, but they also had lower serum albumin concentrations. Risks of short-term postoperative complications, including inflammatory reactions, malignant arrhythmias, constipation, and moderate or more pleural effusions, were also significantly reduced in the SV-group. Additionally, hospitalization cost was lower in the SV-group than that in the MV-group.Conclusions: SV-VATS is suitable for various types of thoracic surgery, and effectively reduce intraoperative bleeding and postoperative thoracic drainage. With less postoperative inflammatory response, it reduces the risk of short-term postoperative complications. It is also able to help to reduce the financial burden of patients.

A surgical Decision-making scoring model for spontaneous ventilation- and mechanical ventilation-video-assisted thoracoscopic surgery in non-small-cell lung cancer patients

“…Xu et al proved that the intraoperative bleeding in SV-VATS is less than MV-VATS, while the operating time is not significantly different between SV-VATS and MV-VATS. Patients showed satisfaction to SV-VATS for its advantages in reducing postoperative complications and accelerating postoperative recovery compared to MV-VATS [ 6 ]. One possible reason may be that SV-VATS attenuate the inflammatory responses caused by surgery and stimulate cellular immune function.…”

“…With the promotion of the concept of enhanced recovery after surgery, the video-assisted thoracoscopic surgery (VATS) has been recommended to perform radical surgery for early-stage NSCLC currently [ 4 , 5 ]. In recent years, with the continuous updating of thoracoscopic instruments, equipment and the increasingly sophisticated surgical skills of surgeons, many thoracic centers have tried to carry out spontaneous ventilation VATS (SV-VATS) in NSCLC patients [ 6 – 9 ]. Evidence has showed that it is safe and feasible to employ SV-VATS in NSCLC patients and the effect of SV-VATS was comparable to mechanical ventilation (MV)-VATS [ 3 , 10 ].…”

“…Evidence has showed that it is safe and feasible to employ SV-VATS in NSCLC patients and the effect of SV-VATS was comparable to mechanical ventilation (MV)-VATS [ 3 , 10 ]. SV-VATS avoids the tracheal injury caused by endotracheal intubation [ 6 ]. Besides, by reducing the use of neuromuscular blocking agents and opioid analgesia during surgery, SV-VATS has a lower risk of postoperative respiratory failure, postoperative hyperalgesia, and even opioid dependence [ 11 ].…”

Retrospectively analyze and compare the efficacy and safety of thoracoscopic-assisted Nuss repair of pectus excavatum under intubation anesthesia and non-intubation anesthesia

“…However, there were differences in WBC, NEUT, and LYMPH the third day after surgery. It may be that the laryngeal mask in the N-IN group was only placed on the throat, without direct contact with the vocal cords, trachea, and bronchus, and did not stimulate the epiglottis, vocal cords, and tracheal mucosa ( 45 , 46 ). The N-IN group had a lower postoperative inflammatory response than the IN group and a shorter duration of the stress state due to the aseptic inflammatory response caused by mechanical stimulation during tracheal intubation anesthesia ( 47 ).…”

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

“…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).…”