Korean J Thorac Cardiovasc Surg.  2018 Oct;51(5):344-349. 10.5090/kjtcs.2018.51.5.344.

Nonintubated Uniportal Video-Assisted Thoracoscopic Surgery: A Single-Center Experience

• Ahn S
• Moon Y
• AlGhamdi Z
• Sung SW

• KMID: 2424751
• DOI: http://doi.org/10.5090/kjtcs.2018.51.5.344

Abstract

BACKGROUND
We report our surgical technique for nonintubated uniportal video-assisted thoracoscopic surgery (VATS) pulmonary resection and early postoperative outcomes at a single center.
METHODS
Between January and July 2017, 40 consecutive patients underwent nonintubated uniportal VATS pulmonary resection. Multilevel intercostal nerve block was performed using local anesthesia in all patients, and an intrathoracic vagal blockade was performed in 35 patients (87.5%).
RESULTS
Twenty-nine procedures (72.5%) were performed in patients with lung cancer (21 lobectomies, 6 segmentectomies, and 2 wedge resections), and 11 (27.5%) in patients with pulmonary metastases, benign lung disease, or pleural disease. The mean anesthesia time was 166.8 minutes, and the mean operative duration was 125.9 minutes. The mean postoperative chest tube duration was 3.2 days, and the mean hospital stay was 5.8 days. There were 3 conversions (7.5%) to intubation due to intraoperative hypoxemia and 1 conversion (2.5%) to multiportal VATS due to injury of the segmental artery. There were 7 complications (17.5%), including 3 cases of prolonged air leak, 2 cases of chylothorax, 1 case of pleural effusion, and 1 case of pneumonia. There was no in-hospital mortality.
CONCLUSION
Nonintubated uniportal VATS appears to be a feasible and valid surgical option, depending on the surgeon's experience, for appropriately selected patients.

Keyword

Nonintubated; Uniportal; Thoracic surgery; Minimally invasive surgical procedures

MeSH Terms

Anesthesia
Anesthesia, Local
Anoxia
Arteries
Chest Tubes
Chylothorax
Hospital Mortality
Humans
Intercostal Nerves
Intubation
Ion Transport*
Length of Stay
Lung Diseases
Lung Neoplasms
Mastectomy, Segmental
Minimally Invasive Surgical Procedures
Neoplasm Metastasis
Pleural Diseases
Pleural Effusion
Pneumonia
Thoracic Surgery
Thoracic Surgery, Video-Assisted*