Tubeless single-port thoracoscopic sublobar resection: indication and safety

Liu, Chao-Yu; Hsu, Po‐Kuei; Chien, Hung-Che; Hsieh, Chih‐Cheng; Ting, Chien‐Kun; Tsou, Mei-Yung

doi:10.21037/jtd.2018.05.119

Cited by 25 publications

(21 citation statements)

References 30 publications

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“…All the results showed that patients operated upon under spontaneous ventilation had a shorter postoperative recovery time when compared with the conventional VATS approach. The other two clinical trials also observed a more encouraging response in patients after using this method . In patients where muscle relaxants were not used during surgery, the most obvious advantage of nonintubated anesthesia was that it could reduce postoperative respiratory complications, promote early postoperative activities and earlier oral feeding.…”

Section: Nonintubated Anesthesiamentioning

confidence: 99%

“…In a single center study reported by Lai et al ., they used a Foley catheter ( n = 441 patients) instead of a 28‐F chest tube ( n = 223 patients) after VATS lobectomy resulting in a statistically significant reduction in pain, shortened mean days until chest tube removal after lobectomy and a smaller proportion of disordered wound healing at the drainage site. The potential benefits of avoiding chest drains are reduced pain, discomfort, and incidence of respiratory complications (Table ).…”

Section: Nonchest Tube Drainagementioning

confidence: 99%

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Tubeless minimally invasive treatment: taking a new step in enhanced recovery after surgery (ERAS)

Shen

Che

2019

Thoracic Cancer

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Section: Nonintubated Anesthesiamentioning

confidence: 99%

Section: Nonchest Tube Drainagementioning

confidence: 99%

Tubeless minimally invasive treatment: taking a new step in enhanced recovery after surgery (ERAS)

Shen

Che

2019

Thoracic Cancer

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“…However, the main pitfall of omitting chest tube placement was residual pneumothorax. [7][8][9] Although the incidence of postoperative pneumothorax has been reported to range from 7.6 to $20% in the literature, a relatively higher percentage of postoperative pneumothorax (40%) has been observed in previous studies. 9,10 In thymectomy, the pulmonary is intact in most cases, and the incidence of pneumothorax is rare.…”

Section: Discussionmentioning

confidence: 93%

Omitting Chest Tube Drainage after Subxiphoid Thoracoscopic Thymectomy

Guo

et al. 2019

Thorac Cardiovasc Surg

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Background This study investigated the feasibility and safety of omitting chest tube drainage after subxiphoid thoracoscopic thymectomy. Methods From July 2018 through October 2018, 20 patients underwent subxiphoid thoracoscopic thymectomy without chest tube drainage. The clinical characteristics and perioperative outcomes of these patients are presented. Results All patients (10 males, 10 females; average age: 53.25 ± 12.50 years old) completed the operation. Chest tube drainage was omitted in a total of 20 patients. The operative time was 89.45 ± 49.80 minutes. No adverse events were observed. The bed-side ultrasound examination of the pleural cavity on the day of surgery showed a thimbleful of effusion and did not require thoracentesis. A postoperative chest roentgenogram on the next morning showed full expansion without pneumothorax in all patients. None of the patients required reintervention with chest drainage through the time of discharge. Conclusion The omission of chest tube drainage may be an alternative procedure for selected patients undergoing thoracoscopic thymectomy. The omission of chest tubes in thymectomy is safe, but further investigation is required.

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“…Non-intubated anaesthesia might prevent the adverse events caused by intubation, ventilation and extubation procedure [ 1 ]. Tubeless approach could further relieve wound pain associated with chest tube placement [ 2 ]. However, full expansion of lung sometimes could not be achieved after operation and presented as pneumothorax [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Tubeless uniportal thoracoscopic wedge resection with modified air leak test and chest tube drainage

2020

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Background To investigate whether tubeless uniportal thoracoscopic wedge resection with modified air leak test and chest tube drainage has better short-term outcomes than non-intubated approach with chest tube drainage. Methods Data were collected retrospectively from January 2017 and December 2019. Tubeless group included 55 patients with pulmonary nodules underwent tubeless uniportal thoracoscopic wedge resection, 211 patients underwent non-intubated uniportal thoracoscopic wedge resection with chest tube drainage were included in drainage group. Peri-operative outcomes between two groups were compared. Results After 1:1 matching, 110 patients remained for analysis, baseline demographic and clinical variables were comparable between the two groups. Mean incision size was 3 cm in both group. Mean operative time was 59.3 min in tubeless group and 52.8 min in drainage group. The detectable mean lowest SpO2 and mean peak EtCO2 during operation was acceptable in both groups. Conversion to intubated ventilation or thoracotomy was not required. No patient failed the air leak test and did not undergo a tubeless procedure. Mean postoperative hospital stay was 1.5 days in tubeless group and 2.5 days in drainage group. Residual pneumothorax or subcutaneous emphysema was not frequent and mild in tubeless group. Side effects were rare and mild, including cough and hemoptysis. No re-intervention or readmission occurred. The postoperative VAS score was significantly lower in tubeless group. Conclusions Tubeless uniportal thoracoscopic wedge resection with modified air leak test and chest tube drainage is feasible and safe for selected patients with peripheral pulmonary nodules, it might reduce post-operation pain and lead to faster recovery.

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Tubeless single-port thoracoscopic sublobar resection: indication and safety

Cited by 25 publications

References 30 publications

Tubeless minimally invasive treatment: taking a new step in enhanced recovery after surgery (ERAS)

Tubeless minimally invasive treatment: taking a new step in enhanced recovery after surgery (ERAS)

Omitting Chest Tube Drainage after Subxiphoid Thoracoscopic Thymectomy

Tubeless uniportal thoracoscopic wedge resection with modified air leak test and chest tube drainage

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